Charles Johnston MD, Dong-Phuong Tran MS, Anna McClung RN BSN

EOS 24-Item Questionnaire (EOSQ) is a parent-reported measurement used to determine the overall well-being of EOS patients. Serial casting is a delay tactic to control curve progression or cure scoliotic deformity in EOS patients

To determine the relationship between treatment outcomes and patient report outcomes in patients treated with serial casting for EOS

Prospective EOS patients treated with serial casting at a single institution EOSQ collection time points: Initiation of casting After removal of last cast in the series Categories: Health-related quality of life Family impact Satisfaction Pearson’s correlation used to correlate total scores and each category and radiographic outcome

24 patients have completed EOSQs Diagnoses: Neuromuscular- 2 Congenital – 2 Syndromic – 5 Idiopathic – 15 Number of casts: 4.2; 2 – 9 Time spent in cast: 9.8 months; 1.8 – 34.2 months Overall major curve decreased by 27% and thoracic height increased by 1.6 cm

Precast (Mean; range) Postcast (Mean; range) p value Age3 years; 1 – years; 3 – 5 Standing height96.5 cm; 69 – cm; 82 – Weight14 kg; kg; 10.7 – Arm span94.9 cm; 69 – cm; 80 – 148 cm<0.000 Major Cobb55°; 28 – °; 10 – Thoracic height (T2 – T12) cm; 103 – cm; 123 – 210<0.000

No significant differences between clinical and radiographic measures and pre-cast EOSQ scores Positive correlation between post-cast major curve and post-cast total score (r=0.41, p=.049) Greater time in cast produced decreased Pain/Discomfort score (r=-0.43, p=0.0036) Larger post-cast Cobb was associated with a lower Emotion score (r=-0.45, p=0.03)

Pre-Cast EOSQ Mean Post-Cast EOSQ MeanP value General Health (GH) Pain/Discomfort (PD) Pulmonary Function (PF) Transfer (TF) Physical Function (PH) Daily Living (DL) Fatigue/Energy Level (FE) Parental Impact (PI) Financial Impact (FI) Child Satisfaction (CS) Parental Satisfaction (PS) Total Precast EOSQ total score mean was – families were unaffected to by their child’s EOS, individual domains ranged from unaffected to neutral In all EOSQ domains, the only significant difference between pre and post-cast was Transfer (TF)

EOS families experience a negligible impact from their child’s cast treatment as measured by the EOSQ. A larger residual major curve leads to a lower total score and emotional domain, while a longer time in cast negatively impacts family’s perception of patient pain.