Pediatric Spine Foundation

Title: Effect of Etiology, Radiographic Severity, and Comorbidities on Baseline Parent-Reported Health Measures for Children with Early-Onset Scoliosis

Authors: Brandon A. Ramo, Anna McClung, Chan-Hee Jo, James O. Sanders, Burt Yaszay, and Matthew E. Oetgen, Pediatric Spine Study Group

Journal: The Journal of Bone & Joint Surgery

Date: March 18, 2020

Excerpt: The etiology of early onset scoliosis is the most important factor in considering EOSQ-24 outcomes

Keywords: EOSQ-24, Early-Onset Scoliosis, C-EOS, Health-Related Quality of Life (HRQoL)



The purpose of this study is to determine the influence of classification of EOS (C-EOS) categories on quality of life in EOS patients. The C-EOS classifies early-onset scoliosis into 4 categories (congenital, neuromuscular, idiopathic, and syndromic) as well as by patient age and curvature of the spine.


  • To measure patient health-related quality of life, patient EOSQ-24 scores were used. The EOSQ-24 is a 24-question survey which measures patient Health Related Quality of Life (HRQoL), family burden, and financial burden.
  • Neuromuscular and Syndromic Scoliosis groups were associated with lower EOSQ scores than Congenital and Idiopathic groups in many EOSQ domains including general health, transfer, daily living, energy level, and emotion. Patients with neuromuscular EOS had the lowest EOSQ scores in general. Congenital and idiopathic EOS did not differ from each other in any EOSQ domain.
  • Curvature of the spine had weak associations with most EOSQ domains.

Discussion Points

  • EOS etiology (Neuromuscular, Syndromic, Congenital, Idiopathic EOS) has a significant influence on Health-Related Quality of Life. Specifically, Syndromic and Neuromuscular EOS patients had lower EOSQ 24 scores than Idiopathic and Congenital patients before treatment.
  • Radiographic measurements of severity such as curvature of the spine had a small influence on EOSQ-24 scores.
  • Coexisting conditions such as developmental delay, supplemental nutrition, tracheostomy, and non ambulatory status led to lower scores in all EOSQ-24 categories. In further statistical testing, however, this association was determined to be statistically insignificant.