Correlation of radiographic parameters and patient satisfaction in adolescent idiopathic scoliosis treated with posterior screw-dual-rod instrumentation.

Abstract

In surgical treatment of adolescent idiopathic scoliosis (AIS), only a few studies measure both, radiological parameters and PROMs and correlate them. Prospectively collected AIS-data of one scoliosis-center within a multicenter German-Spine-Society-Study. All patients underwent instrumented posterior spinal correction and fusion with pedicle-screw-dual-rod-systems from 05/2019 to 01/2021. The data were retrospectively analyzed. age 11-17years, follow-up (FU) at least 12months. Clinical data, radiographic parameters, and PROMs (SRS-30-questionnaire) were collected. 100% of patients had X-ray images, 88.2% completed SRS-30. Parameters were given as mean ± SD. Differences and subdivision by lower instrumented vertebra (LIV) were analyzed by students t-test (significancy a = 0.05), associations by Pearson's correlation. Total of 51 patients: 15 ± 1.4years, BMI 20.7 ± 3.7kg/m2, FU 16.6 ± 6.1months, fusion length 9.2 ± 2.3 segments, implant density 93 ± 9%, surgical time 215 ± 71min, mean blood loss 504 ± 360ml. Mean preoperative Cobb angle of main curve 64 ± 14°, of secondary main curve 46 ± 12°, corrected by 68 ± 11%, 56 ± 17%, respectively. Mean thoracic rib and lumbar hump significantly decreased by -8.5 ± 7.0° and -7.7 ± 8.9° (p < 0.5). High thoracic rib hump almost unchanged, -0.4 ± 2.8° (p = 0.3). Thoracic kyphosis (-0.9 ± 12.8°, p = 0.6), lumbar lordosis (1.5 ± 10.1°, p = 0.3), clavicle angle (-0.5 ± 2.7°) and spinopelvic parameters (p > 0.5) did not significantly change, only LIV-tilt from 24.5 ± 6.7° to 6.5 ± 4.3° (p < 0.05). PROMs significantly improved (p < 0.05), no significant improvement for function/activity (p = 0.4). Preoperative mean total-score was 3.6 ± 0.5, 4.2 ± 0.3 at FU(p < 0.05). Self-image improved in 67%. Moderately strong correlation for PROMs: the better LIV-tilt (r = -0.5) correction and the shorter surgery time (r = -0.4), the better SRS-30 total-score. No correlation for curve correction and patient's satisfaction. In summary, results of this study demonstrate good surgical correction and significant improvement of most PROMs.