Does the Quality of Life in Operated Patients with Adolescent Idiopathic Scoliosis correspond with the Radiographic Parameters?

Objectives: Traditionally, scoliosis surgery is aimed at attaining a fused, balanced and painless spine. With improvement in surgical and instrumentation techniques, spine surgeons strive to achieve higher degree of Cobb’s angle and rib hump correction with the idea of greater patient satisfaction. The aim of this study was to determine the patients’ satisfaction using SRS-22 questionnaire and their correlations with the radiographic changes.

Materials and methods: A prospective study was conducted in a tertiary referral cen re using the Scoliosis Research Society-22 (SRS-22) questionnaire during the patients’ annual follow up, betwee February to April 2014. Thirtyseven patients who met the inclusion criteria were enrolled. Results: The mean pre-operative Cobb’s angles were 57.8o ± 12.7o and mean post-operative angle of 20.0o ± 10.4o, resulting in average correction of 65.9 ± 14.4%. Mean preoperative rib hump was 61.1 ± 15.4 mm with mean postoperative rib hump of 15.8 ± 17.8 mm, resulting in average reduction of 77.7 ± 23.7%. Mean of post-operative total SRS score was 4.1 ± 0.5. Using Spearman rank correlation, the percentage of Cobb’s angle correction versus the SRS-22 score showed correlation of 0.17 (P=0.33) while the percentage of rib hump reduction versus SRS-22 score showed a correlation of 0.11 (P=0.53).

Conclusion: In this study, the average total SRS-22 score was 4.1 ± 0.5 (range, 3.1-4.9) post-operatively indicating very high satisfaction rate overall. Despite attempts at greater curve correction and rib hump reduction, there is no direct correlation between patient satisfaction and radiographic parameters.

Retained intraspinal bullet: a rare case in a visitor to malaysia - a case report

ABSTRACT

Firearm injuries to the spine commonly present with acute neurology caused by direct penetration or indirectly from concussive effects of bullet impact on the vertebral column. We report a case of delayed neurologic presentation of retained intra-spinal bullet in a 42 year-old African who had chronic low back pain and sciatica with a past history of gunshot injury to the spine and radiograph revealed a bullet at the L4-5 disc level. Intra-operative exploration showed a fibrous mass around the bullet compressing on the L4 existing nerve root and L5 traversing nerve root. Removal of the retained bullet resulted in a good clinical outcome with complete resolution of symptoms.

KEY WORDS

Intra-spinal bullet, gunshot injury.