Rib-on-Pelvis Deformity and Reported Pain in Neuromuscular Early-Onset Scoliosis

Area of Science:

• Orthopedics
• Pediatric Spine Surgery
• Radiology

Background:

• Neuromuscular early-onset scoliosis (N-EOS) can cause severe spinal deformities, including pelvic obliquity.
• Rib-on-pelvis deformity (ROP), where ribs contact the pelvis, is a complication of severe pelvic obliquity in N-EOS.

Purpose of the Study:

• To investigate the association between ROP and reported pain and health-related quality of life (HRQOL) in N-EOS patients.
• To determine if ROP is a significant factor contributing to pain and reduced HRQOL.

Main Methods:

• A multicenter international registry of nonambulatory N-EOS patients (2012-2022) was analyzed.
• ROP was assessed radiographically, and pain/HRQOL were evaluated using the EOSQ-24 questionnaire.
• Surgical and nonsurgical patients were included; exclusion criteria applied for radiographic and questionnaire timing discrepancies.

Main Results:

• 37% of 225 N-EOS patients exhibited ROP.
• ROP was significantly associated with increased pain frequency and severity (P<0.001).
• ROP correlated with worse general health, vocalization difficulty, shortness of breath, and sitting upright ability (P<0.05).
• Patients with ROP showed greater pain reduction after surgical intervention.

Conclusions:

• ROP occurs in approximately 37% of N-EOS cases and is linked to heightened pain and diminished HRQOL.
• ROP may be a primary pain generator in N-EOS.
• Surgical correction of ROP leads to significant pain improvement.