Transitioning spine care from the pediatric to adult center: Challenges and future directions.

STUDY

DESIGN

Anonymous, survey-based prospective study.

OBJECTIVES

The objective of this study was to evaluate the current practice patterns and opinions of surgeons treating pediatric spinal deformity patients into adulthood.

METHODS

An electronic survey regarding the transition process of pediatric patients into adulthood was administered to members of the ISSG (International Spine Study Group) and HSG (Harms Study Group). The survey covered themes such as protocols of transition of care, deformities recommended for follow-up into adulthood and institutional capability as well as organization for future follow-up into adulthood. Results of the survey were described in frequencies. Statistical analyses to detect differences in responses between groups were performed when appropriate.

RESULTS

A total of 56 responses were analyzed. 85 % of the members of the HSG responded to the survey (41 out of 48 surgeons), and 42 % of members from the ISSG responded (15 out of 36). A third of the respondents described having the institutional capability to follow-up with patients of any age. Most (60 %) of the ISSG members continue to follow-up with their pediatric patients into adulthood. For the question about treatment plans for patients who cannot be followed due to age, there was significant differences in referral patterns following pediatric care (p = .0006). Furthermore, HSG significantly discussed more about transitional care planning with patients and their families compared to ISSG (p = .001).

CONCLUSIONS

Although more than 80 % of respondents somewhat discussed transitional care for spinal deformity, more than 90 % do not have a formal transitional care protocol. There is a clear lack of both uniformity and standards for transitional care for spinal deformity. It is imperative to develop and disseminate standards of transitional care for youth with spinal deformities. This work encourages all specialty societies including the Scoliosis Research Society and all professionals involved with youth transitional care to lead future work.

LEVEL OF EVIDENCE: V.