Pediatric Spine Foundation

Title: Bigger is Better: Larger thoracic height is associated with increased health related quality of life at skeletal maturity

Authors: Benjamin D. Roye, Matthew E. Simhon, Hiroko Matsumoto, Sumeet Garg, Gregory Redding, Amer Samdani, John T. Smith, Paul Sponseller, Michael G. Vitale, Children’s Spine Study Group, Growing Spine Study Group

Journal: Spine Deformity

Date: March 11, 2020

Excerpt: Once 18 cm of actual thoracic height or 80% of expected thoracic height is achieved, health related quality of life (HRQoL) continues to improve as thoracic height increases in skeletally mature patients with non-idiopathic EOS.

Keywords: Scoliosis, Early onset scoliosis, Thoracic height, Quality of life, Pulmonary function

Summary:

Purpose

The purpose of this study is to evaluate the association between thoracic height and health related quality of life (HRQoL) at skeletal maturity in patients with early onset scoliosis (EOS).

Results

  • Results were gathered using thoracic height and the early onset scoliosis questionnaire (EOSQ-24 data from 32 locations. At a minimum of 18 cm of thoracic height for patients with congenital, neuromuscular, and syndromic EOS and 20 cm for patients with idiopathic EOS, HRQoL continued to improve with increases in thoracic height at skeletal maturity.
  • Patients with a thoracic height <22 cm had a significantly higher mean major curve Cobb angle (59° versus 39°) which likely contributed to their decreased thoracic height and their higher likelihood of undergoing operative procedures.

Discussion Points

  • Previous research suggests a minimum thoracic height of 18-22 cm to avoid pulmonary issues and related problems.
  • Patients with idiopathic EOS had a higher minimum thoracic height for improvement, possibly due to their larger average size and higher caregiver expectations for HRQoL.
  • This study has high external validity as the study patients were drawn from 32 centers across the United States. Therefore, this study has high generalizability for EOS patients across the country.