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Does ventilator use status correlate with quality of life in patients with early-onset scoliosis treated with rib-based growing system implantation?



Pulmonary function and quality of life (QOL) are important outcome measures for patients with early-onset scoliosis (EOS) undergoing rib-based growing system (RBGS) implantation. The Assisted Ventilation Rating (AVR) measures ventilator requirements in this population. A higher, more severe, score implies negative changes in QOL. The EOS Questionnaire (EOSQ) is a validated outcome measure. Paired measurements for both ratings were compared to clarify correlation between ventilator status and QOL. Secondary analysis aimed at defining QOL between more broad subgroups defined by ventilator use.


AVR and EOSQ scores were extracted from the Pediatric Spine Study Group database for patients 10 years of age and under. Instances were excluded if the time between AVR and EOSQ assessment was greater than 6 months. Scores were compared using Spearman correlation coefficient. Subgroup analysis included control for age, gender, and etiology. Secondary analysis was performed for broad functional grouping using ranked analysis of variance for repeated measures using median scores.


Two thousand five hundred and forty-two instances of paired EOSQ and AVR in 329 patients were analyzed. A statistically significant weak correlation between AVR and EOSQ was identified in Child’s Health Related QOL and Family Impact sections, in nine subsets. Subgroup analysis showed little variation, except increased correlation in female patients to near moderate level. Analysis of variance for demonstrated decreased medians for all subdomains when comparing those mechanically ventilated to patients who did not require ventilation.


Ventilator status tracks with QOL were measured by EOSQ. A more severe AVR is negatively correlated with most domains of the EOSQ for patients with EOS who have undergone RBGS implantation. The strength of this correlation is weak, and so AVR alone may be insufficient to precisely determine QOL in this population.

Level of evidence

Level-III, Retrospective.

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Authors would like to acknowledge the contributions of Robert B. Campbell, MD (Children’s Hospital of Philadelphia, Philadelphia, PA, USA) and Hiroko Matsumoto, PhD (Columbia University, New York City, NY, USA) for advice in the development of this project.



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SN, AQ, JS, JG, JP, and OM: writing—original draft preparation, approval of final version of manuscript, and agree to be accountable for the work. AS, JF, SG, MG, and JS: data collection, approval of final version of manuscript, and agree to be accountable for the work. PC: data collection, approval of final version of manuscript, agree to be accountable for the work, and writing—original draft preparation.

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Correspondence to Sarah Beth Nossov.

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Approved by IRB via Shriners Hospitals for Children and through participation in PSSG.

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Data obtained from Pediatric Spine Study Group (PSSG), available upon query.

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Nossov, S.B., Quinonez, A., SanJuan, J. et al. Does ventilator use status correlate with quality of life in patients with early-onset scoliosis treated with rib-based growing system implantation?. Spine Deform 10, 943–950 (2022).

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  • Assisted Ventilation Rating
  • Early-onset scoliosis
  • Quality of life
  • Thoracic
  • Insufficiency syndrome
  • Rib-based growing system