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)
Objective : 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.
Material / Patients and Methods : 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.
Results : 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.
Keywords : Polyhandicap, Scoliosis, Multidisciplinarity, Hetero-Evaluation
Disclosure of interest : None