Communication Affichée: Best of poster
Le 15/10/2021 de 09:00 à 10:30
Utilisation de nouveaux outils d'évaluation à destinée des patients polyhandicapés : à propos des prises en charge médico-chirurgicales des scolioses sévères
Hugo BESSAGUET (Saint-Etienne, France), Bruno DOHIN (Saint-Etienne, France), Vincent GAUTHERON (Saint-Etienne, France), Marie-Christine ROUSSEAU (Marseille, France)
Objectif : Polyhandicap is a chronic and definitive pathological situation that is highly complex, due to the heterogeneity of its etiologies. The medical and surgical management of scoliosis, a prevalent complication during the growth of polyhandicaped subjects, has various objectives which aim mainly at limiting the occurrence of over-handicaps, by ensuring greater comfort. We hypothesize that spinal fusions confer a benefit on the deficiencies, capacities, and quality of life in those subjects, which is measurable by the Polyhandicap Severity Scale (PSS), a newly published specific hetero-evaluation tool.
Matériel/Patients et méthodes : We conducted a monocentric retrospective study focusing on a cohort of polyhandicaped subjects, who have undergone posterior spinal fusion between 2009 and 2020. Variations of the PSS score and subscores were evaluated 6 months before and 12 months after surgery. Neuro-orthopedic data and perioperative complications were also recorded.
Résultats : In this preliminary study, we included 5 subjects (mean age at surgery: 14,8-years-old) suffering from severe scoliosis (mean Cobb angle: 73,6°) and responsible for orthopedic deformities and multi-systemic impairments. Mean variation between pre and post-operative’s PSS indicated that the level of severity was lower 1 year after surgery (-3,1 points), even if each participant had at least one surgical complication (i.e osteoporotic fracture, surgical site infection, acute organ failure).
Discussion - Conclusion : The indication for surgery, therefore, requires a precise multidisciplinary evaluation of the benefit-risk balance. In that way, specific hetero evaluations can be useful tools. Adding quality of life parameters and conducting prospective evaluations may help to improve those complex care projects.
Mots clés : Polyhandicap, Scoliosis, Multidisciplinarity, Hetero-Evaluation
Liens d'intérêts : None