Determinants of Long-Term Transfer Difficulty and Global Caregiver Satisfaction after Neuromuscular Scoliosis Surgery: A Dissociation between Task-Specific Burden and Perceived Benefit.

INTRODUCTION

Caregiver satisfaction after neuromuscular scoliosis (NMS) surgery is generally high; however, the relationship between task-specific caregiving burden and global treatment satisfaction remains unclear. This study aimed to identify patient- and caregiver-related determinants of transfer difficulty and global satisfaction in the long-term postoperative period.

METHODS

This cross-sectional follow-up study included individuals who underwent posterior spinal fusion for NMS between 2012 and 2020 and were ≥18 years at survey distribution. Caregivers completed a modified Bridwell questionnaire using 0-10 scales. Multivariate linear regression identified determinants of transfer difficulty and global satisfaction, with false discovery rate (FDR) correction applied.

RESULTS

Sixty-two caregivers responded (63% response rate). In the patient-related model, higher adult body weight (β=-0.14, p_FDR=0.077) and greater residual Cobb angle (β=-0.082, p_FDR=0.065) showed trends in transfer difficulty scores, though neither reached the p_FDR<0.05 threshold. Among caregiver-reported domains, difficulty with changing clothes (β=0.75, p_FDR=0.081) demonstrated a similar trend. Global satisfaction was significantly associated with better respiratory status (β=0.36, p_FDR=0.023) and improved swallowing (β=-0.16, p_FDR=0.047). Transfer difficulty showed no association with global satisfaction (β=-0.007, p_FDR=0.90).

CONCLUSIONS

These findings represent exploratory associations observed at a single time point in adulthood and do not imply causal relationships. Transfer difficulty in adulthood appears to be primarily associated with body size and residual spinal deformity, whereas global satisfaction is primarily associated with improvements in respiratory and swallowing function. These findings indicate a dissociation between task-specific caregiving burden and global treatment satisfaction, suggesting that caregivers may affirm long-term treatment value despite ongoing physical challenges.