Outcomes of Surgical Treatment in Male Versus Female Adolescent Idiopathic Scoliosis Patients

Abstract

This research was part of a multicenter study of the surgical treatment of adolescent idiopathic scoliosis (AIS). To compare the radiographic and perioperative surgical treatment outcomes of male AIS patients with female AIS patients. The results of treatment in male patients with idiopathic scoliosis have not been widely reported. Only 1 study has evaluated the differences in operative treatment outcomes between male and female patients with AIS. Data were collected for patients who met the indications for surgical intervention at 8 separate institutions. Radiographic, perioperative, and pulmonary function variables for male and female AIS patients treated surgically were analyzed. A univariate analysis of variance with the alpha level adjusted to P < or = 0.01 was used. The data for 547 (449 females and 98 males) patients were included in this analysis. Posterior instrumentation (vs. anterior instrumentation) was performed slightly more often in males than females (51% vs. 44%, respectively). The preoperative primary curve magnitude was similar for both genders, but flexibility was less in males (44% vs. 49%; P = 0.01). Postoperative percent correction and the ratio of percent correction to preoperative flexibility were both similar in males versus females. Analysis of the perioperative variables yielded that estimated blood loss was higher in males than females (1342 vs. 898 cc, respectively; P = 0.001). Males reported greater pain on postoperative day 1 (6.1 vs. 5.4; P = 0.01), however, conversion to oral pain medication was similar for both. Preoperative and postoperative pulmonary function was similar for both genders. Male AIS patients had slightly more rigid primary curves compared to females but a similar degree of postoperative scoliosis correction. Differences in the preoperative status and perioperative course did not compromise the outcomes of surgical treatment as in all other measures; the results were comparable between the genders.