Radiographic and clinical outcomes in adolescent idiopathic scoliosis corrective fusion surgery: a one year follow up

Abstract

Background: Adolescent idiopathic scoliosis (AIS) is a complex three-dimensional deformity of the spine, characterized by a Cobb angle of at least 10°. The goal of surgery is not only to prevent progression, but restoration of sagittal and coronal balance, protection of cardiopulmonary function and improvement of cosmesis. In this study we reviewed the impact of deformity correction surgery in terms of radiology and patient reported outcomes.

Method: Data extracted from a prospective maintained database, between 2003 and 2022, was retrospectively analysed for pre- and post-operative patient reported outcome measures, captured using the Scoliosis Research Society-22 (SRS-22) questionnaire, as well as radiological parameters. Forty-four patients with AIS were identified with pre- and post-operative PROMs. The average age at survey was 15 years with 84% female. 38% had a Lenke 1 curve and three patients had Lenke 6 curves. 73% had posterior approach surgery.

Results: There was a total improvement in SRS-22 scores by 7.8% with 75% achieving MCID. Patients reported significant satisfaction with treatment 4.8/5 and improvement of self-image with a change of 1.1. However, no difference in function and pain were recorded. Overall, proximal thoracic (PT) curves improved from 24° to 11°, main thoracic (MT) curve from 55° to 19° and thoracolumbar/lumbar curves (TL/L) from 45° to 41°, respectively. MT was 32% and 67%. That for TL/L was 57% and 71% respectively.

Conclusion: Surgery yields significant main curve correction which corresponds to high patient reported satisfaction rate. Although total SRS-22 score yielded a 7.8% improvement, sub-analysis of self-image showed the most significant improvement of 4.5/5.