Spinal deformity transitional care from pediatric to adult population: a descriptive study.

Abstract

Spinal deformity can develop in childhood and adulthood. There is often a loss of follow-up for these patients during the transition to adulthood. The aim of this study was to describe the management of those patients. Hypothesis transitional care enhances patient's adherence to long-term follow-up. A consultation was organized between two orthopedic surgery departments, one pediatric and the other adult, to ensure a transitional follow-up. All patients followed up in the pediatric department for spinal deformity between 2019 and 2021 were included (Ped group). Patients referred to the adult department were analyzed (Ped_Ad group). Data collected included type of deformity, age at first and last consultation, overall follow-up time, and number lost to follow-up (LTFU). Overall, 383 patients were included: 11% were referred to an adult center (Ped_Ad), and 89% remained in pediatrics (Ped). Age at first and last consultation was significantly higher in the Ped_Ad group. Mean follow-up time was 4 years in both groups. In the Ped group, 18% of patients had undergone surgery, versus 61% in the Ped_Ad group. The rate of LTFU was twice higher in the Ped group (25%) than in the Ped_Ad group (12%), but the difference was not significant (p = 0.07). Among LTFU, patients aged between 14 and 16 years were the most represented (53%), and they were most often unoperated patients in the Ped group. When adult follow-up was organized, adherence to follow-up was better. This would enable patients to be managed earlier, in the event of worsening of an unoperated deformity. IV.