Outcome of Surgery for Adolescent Idiopathic Scoliosis

Abstract

Research Article| December 01 2019 Outcome of Surgery for Adolescent Idiopathic Scoliosis AAP Grand Rounds (2019) 42 (6): 64. https://doi.org/10.1542/gr.42-6-64 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Outcome of Surgery for Adolescent Idiopathic Scoliosis. AAP Grand Rounds December 2019; 42 (6): 64. https://doi.org/10.1542/gr.42-6-64 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: adolescent idiopathic scoliosis, surgical outcome, pain Source: Helenius L, Diarbakerli E, Grauers A, et al. Back pain and quality of life after surgical treatment for adolescent idiopathic scoliosis at 5-year follow-up: comparison with healthy controls and patients with untreated idiopathic scoliosis. J Bone Joint Surg Am. 2019; 101(16): 1460– 1466; doi: https://doi.org/10.2106/JBJS.18.01370Google Scholar Investigators from multiple institutions in Finland and Sweden conducted a case control study to compare long-term pain and quality of life in patients with adolescent idiopathic scoliosis (AIS) who underwent surgical treatment, consisting of posterior spinal fusion with pedicle screws, to that of untreated AIS patients and individuals without AIS. Cases were patients with AIS who underwent surgical treatment when they were between 12 and 19 years old at a single center by a single orthopaedic surgeon. These patients completed the Scoliosis Research Society-24 (SRS-24) questionnaire at minimum of 5 years after surgical treatment for AIS. The SRS-24 is designed to measure disease-specific quality of life across multiple domains. The 2 sets of controls were selected from the populations of other studies conducted by the authors1,2 ; one control from each set was age- and gender-matched to a case. The untreated AIS control group was patients from 1 of 6 centers in Sweden who were diagnosed with AIS when they were 10–17 years old and had a Cobb angle of ≥10°. Healthy controls were selected from the general population in Sweden. Participants in both control groups completed the SRS-22r, which is a revised version of the SRS-24. For the study, SRS-24 scores from 4 domains in cases, including pain, self-image, function, and activity, were compared to SRS-22r scores in controls for the same domains. Wording of the specific questions in these domains in the SRS-24 or SRS-22r are either the same or close. Scores between the cases and 2 control groups were compared using ANOVA. There were 49 cases with AIS who underwent surgical treatment. Mean Cobb angle in these individuals was 53.2° + 7.3° preoperatively, and 11.7° + 6.0° at 2 years postoperatively. The mean age of cases was 22 years, and they had a mean follow-up period of 6.2 years. Among those in the untreated AIS group, the mean Cobb angle at the time of diagnosis was 27.7° + 10.1°. Scores for the domains of pain, self-image, and activity were significantly better in cases than in untreated AIS controls (P values <.001, .014, and <.001, respectively); there was no significant difference between these groups in the domain of function (P=.26). There were also no significant differences for the domains of pain, self-image, and activity between cases and healthy controls, but scores in the domain of function were significantly better in healthy controls than in cases (P<.001). The authors conclude that patients with surgical treatment of AIS had improved pain and health-related quality of life compared to those with untreated AIS. Dr Hennrikus has disclosed no financial relationship relevant to this commentary.... You do not currently have access to this content.