Perspective from Laurel C. Blakemore, MD
June 25, 2018
2 min read
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Serial casting had negative effect on HRQoL of patients with idiopathic EOS

Providers should consider risks and benefits of treatments for early-onset scoliosis, including how they effect on quality of life.

Perspective from Laurel C. Blakemore, MD
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PHILADELPHIA — Serial casting was a safe and noninvasive treatment for early-onset scoliosis, but this treatment had a negative impact on the patient’s health-related quality of life, even after the cast was removed, according to a presenter, here.

 “[Casting] does cause widespread negative effects in quality of life and burden of care during the treatment,” David Price Roye, MD, said at the Scoliosis Research Society Annual Meeting. “Providers must be careful and consider the risks and benefits of treatments for [early-onset scoliosis] EOS including the impacts on quality of life.”

Roye and his colleagues performed a retrospective cohort study and identified 91 patients with EOS from the Children’s Spine Study Group and Growing Spine Study Group databases. Patients were initially casted at a mean age of 2.1 years and casts were removed after a mean of 4.1 years. For 8 weeks to 16 weeks, patients were serially casted, and, after casting, various treatment was used. There were 59 patients who were placed in the idiopathic EOS group and 32 patients who were placed in the non-idiopathic EOS group. Investigators then compared idiopathic and non-idiopathic patients with age-matched norms. The 24-item EOS questionnaire score was used to compare health-related quality of life before, during and after serially casting.

The pre-cast baseline scores in the idiopathic group were similar to those of the age-matched controls, apart from the burden domains. Transfer and emotion declined in the idiopathic group while they were in-cast and they did not recover afterwards. Physical function, daily living, overall HRQoL and burden decreased in the idiopathic group, as well. However, decreases in transfer and emotion scores were the only changes detected in the non-idiopathic group.

“During casting, more of the quality of life measures dropped among both patient cohorts; not surprising given the restrictive nature of casting,” he said. “However, the idiopathic and non-idiopathic groups behaved differently after casting. The idiopathic group had a low HRQoL to start. Out-of-cast, the non-idiopathic [group’s] quality of life exceeded baseline in most subdomains. The idiopathic group saw no improvement or negative quality of life persistence in the emotion and the transfer domains when they came out of the cast,” Roye said. – by Monica Jaramillo

Reference:

Roye DP, et al. Paper #58. Presented at: Scoliosis Research Society Annual Meeting; Sept. 6-9, 2017; Philadelphia.

For more information:

David Price Roye, MD, can be reached at Morgan Stanley Children’s Hospital of New York Presbyterian, Columbia University Medical Center, 3959 Broadway, Room 800 North, New York, NY 10032; email: dpr2@columbia.edu.

Disclosure: Roye reports no relevant financial disclosures.