1083 Investigating Quantitative Long-term Outcomes of Surgical Intervention in Patients With Adolescent Idiopathic Scoliosis and Cobb Angles Between 40 and 50 Degrees: A Retrospective Analysis of the Harms Study Group Scoliosis Outcomes Database Registry

Abstract

INTRODUCTION: Many patients with Adolescent Idiopathic Scoliosis (AIS) are successfully managed with conservative methods, and when indicated, with additional surgical intervention. However, current evidence is limited in supporting therapeutic recommendations for AIS patients with Cobb angles between 40-50 degrees. METHODS: De-identified patient data was acquired with permission from the Harms Study Group. Patients 10-21 years old with AIS and 40-50-degree Cobb angles at the time of baseline data collection were grouped based on whether they received operative (op) or nonoperative (non-op) management. Baseline and 2-year follow-up Scoliosis Research Society 22-item questionnaire (SRS-22) scores were analyzed using two-tailed Student’s t-tests and Chi-square tests. Significance level was set to alpha = 0.05. RESULTS: A total of 919 patients were analyzed; 863 patients in the op group, and 56 patients in the non-op group. There was no significant difference between op and non-op groups in the distribution of spinal curvature locations at baseline (p = 0.52). The op and non-op groups were found to be significantly different in both average baseline (3.9 vs. 4.1, p = 0.002), and average 2-year follow-up (4.4 vs. 4.0, p < 0.001) SRS-22 scores. The average change in pairwise SRS-22 scores over the 2-year period also significantly differed between op (+0.5) and non-op (-0.1) groups (p < 0.001). CONCLUSIONS: Our results showed significantly higher 2-year follow-up average SRS-22 scores, as well as a markedly positive pairwise score change for the operative group, when compared to the non-operative group. This demonstrates better long-term outcomes amongst patients who underwent surgery rather than conservative management alone. Our study provides novel evidence that supports recommending surgical intervention for AIS patients with Cobb angles between 40-50 degrees.