The Ecuador Pediatric Spine Deformity Surgery Program: An SRS-GOP Site, 2008-2016.
STUDY DESIGN: Retrospective case series.
OBJECTIVES: The purpose of this study is to (1) describe the development of our Spinal Deformity Program; (2) assess the surgical outcomes, including health-related quality of life (HRQOL), radiographic measures, and complications; and (3) explore predictors for HRQOL outcomes.
SUMMARY OF BACKGROUND DATA: The Scoliosis Research Society (SRS) is very interested in international program site development to provide safe surgical care for children in low- and middle-income countries (LMICs). There is a need for reporting program development and outcomes from these sites. After several years of building local relations and infrastructure, our program started performing spine surgery in 2008.
METHODS: All operations were performed at Roberto Gilbert Elizalde Children's Hospital in Guayaquil, Ecuador. At a minimum of two years and average of four years postoperatively, patients received a clinical evaluation, radiographs, and the Spanish SRS-22r questionnaire.
RESULTS: Twenty-eight (74%) of the 38 children who received spine surgery between May 2008 and 2015 are included in this study. Twenty-three (82%) were female with an average age of 14 years at the time of surgery and 18 years at follow-up. The mean total SRS-22r score was 4.3 and mean percentage major curve correction was 57%. Curve location was found to be a significant predictor of postoperative SRS-22r scores with double curves having poorer scores (p = .004). Two complications were pseudarthrosis and postoperative delayed paraplegia, both of which resolved after revision surgery. No infections or other long-term complications have occurred.
CONCLUSIONS: The development of equitable surgical care for all children is a primary goal of the SRS. Undertaking the task to perform surgery in LMIC comes with the responsibility to monitor and maintain the highest quality. Our program was safely developed to address the surgical needs of children with good midterm HRQOL outcomes, adequate radiographic curve correction, and no permanent complications.
LEVEL OF EVIDENCE: Level IV.
Adolescent; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Male; Program Development; Quality of Life; Retrospective Studies; Scoliosis; Surveys and Questionnaires; Time Factors; Treatment Outcome; Young Adult
Ecuador; International program development and outcomes; Pediatric; SRS-GOP; Spine deformity surgery
Fletcher, A. N., Schwend, R. M. The Ecuador Pediatric Spine Deformity Surgery Program: An SRS-GOP Site, 2008-2016. Spine Deform 7, 220-227 (2019).