Spinal Deformity Transitional Care from Pediatric to Adult Population: a Descriptive Study

Overview

Journal Spine Deform

Publisher Springer Nature

Date 2025 Feb 16

PMID 39956845

Authors

Melanie Ta

Marc Khalife

Christophe Glorion

Pierre Guigui

Stephanie Pannier

Emmanuelle Ferrero

Affiliations

Soon will be listed here.

Abstract

Background: Spinal deformity can develop in childhood and adulthood. There is often a loss of follow-up for these patients during the transition to adulthood. The aim of this study was to describe the management of those patients. Hypothesis transitional care enhances patient's adherence to long-term follow-up.

Methods: A consultation was organized between two orthopedic surgery departments, one pediatric and the other adult, to ensure a transitional follow-up. All patients followed up in the pediatric department for spinal deformity between 2019 and 2021 were included (Ped group). Patients referred to the adult department were analyzed (Ped_Ad group). Data collected included type of deformity, age at first and last consultation, overall follow-up time, and number lost to follow-up (LTFU).

Results: Overall, 383 patients were included: 11% were referred to an adult center (Ped_Ad), and 89% remained in pediatrics (Ped). Age at first and last consultation was significantly higher in the Ped_Ad group. Mean follow-up time was 4 years in both groups. In the Ped group, 18% of patients had undergone surgery, versus 61% in the Ped_Ad group. The rate of LTFU was twice higher in the Ped group (25%) than in the Ped_Ad group (12%), but the difference was not significant (p = 0.07). Among LTFU, patients aged between 14 and 16 years were the most represented (53%), and they were most often unoperated patients in the Ped group.

Conclusion: When adult follow-up was organized, adherence to follow-up was better. This would enable patients to be managed earlier, in the event of worsening of an unoperated deformity.

Level Of Evidence: IV.

References

Lonstein J . Adolescent idiopathic scoliosis. Lancet. 1994; 344(8934):1407-12. DOI: 10.1016/s0140-6736(94)90572-x. View

Duval-Beaupere G, Lamireau T . Scoliosis at less than 30 degrees. Properties of the evolutivity (risk of progression). Spine (Phila Pa 1976). 1985; 10(5):421-4. View

Pesenti S, Jouve J, Morin C, Wolff S, Sales de Gauzy J, Chalopin A . Evolution of adolescent idiopathic scoliosis: results of a multicenter study at 20 years' follow-up. Orthop Traumatol Surg Res. 2015; 101(5):619-22. DOI: 10.1016/j.otsr.2015.05.004. View

Yu S, Ng C, Cheung J, Shea G . Post-Maturity Progression in Adolescent Idiopathic Scoliosis Curves of 40° to 50°. J Bone Joint Surg Am. 2023; 105(4):277-285. DOI: 10.2106/JBJS.22.00939. View

Marty-Poumarat C, Scattin L, Marpeau M, Garreau de Loubresse C, Aegerter P . Natural history of progressive adult scoliosis. Spine (Phila Pa 1976). 2007; 32(11):1227-34. DOI: 10.1097/01.brs.0000263328.89135.a6. View

Charosky S, Guigui P, Blamoutier A, Roussouly P, Chopin D . Complications and risk factors of primary adult scoliosis surgery: a multicenter study of 306 patients. Spine (Phila Pa 1976). 2012; 37(8):693-700. DOI: 10.1097/BRS.0b013e31822ff5c1. View

Bradford D, Tay B, Hu S . Adult scoliosis: surgical indications, operative management, complications, and outcomes. Spine (Phila Pa 1976). 2000; 24(24):2617-29. DOI: 10.1097/00007632-199912150-00009. View

Weinstein S, Dolan L, Spratt K, Peterson K, Spoonamore M, Ponseti I . Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA. 2003; 289(5):559-67. DOI: 10.1001/jama.289.5.559. View

Blum R, GARELL D, HODGMAN C, Jorissen T, Okinow N, Orr D . Transition from child-centered to adult health-care systems for adolescents with chronic conditions. A position paper of the Society for Adolescent Medicine. J Adolesc Health. 1993; 14(7):570-6. DOI: 10.1016/1054-139x(93)90143-d. View

10.

Roux A, Beccaria K, Blauwblomme T, Mahlaoui N, Chretien F, Varlet P . Toward a transitional care from childhood and adolescence to adulthood in surgical neurooncology? A lesson from the Necker-Enfants Malades and the Sainte-Anne Hospitals collaboration. J Neurosurg Pediatr. 2021; 28(4):380-386. DOI: 10.3171/2021.3.PEDS2141. View

11.

de Oliveira R, Kishimoto S, de Souza D, Fernandes P, Marini R, Appenzeller S . The importance of transition from pediatric to adult rheumatology care in juvenile idiopathic arthritis. Expert Rev Clin Immunol. 2021; 17(2):155-161. DOI: 10.1080/1744666X.2020.1865157. View