Peter O Newton1,2, Masayuki Ohashi3, Tracey P Bastrom4, Carrie E Bartley4, Burt Yaszay4,5, Michelle C Marks6, Randal Betz7, Lawrence G Lenke8, David Clements9. 1. Orthopedics and Scoliosis Division, Rady Children's Hospital, 3020 Children's Way, MC 5062, San Diego, CA, 92123, USA. pnewton.rady@gmail.com. 2. Department of Orthopedic Surgery, University of California, San Diego, CA, USA. pnewton.rady@gmail.com. 3. Department of Orthopedic Surgery, Niigata University Medical and Dental Hospital, Niigata, Japan. 4. Orthopedics and Scoliosis Division, Rady Children's Hospital, 3020 Children's Way, MC 5062, San Diego, CA, 92123, USA. 5. Department of Orthopedic Surgery, University of California, San Diego, CA, USA. 6. Setting Scoliosis Straight Foundation, San Diego, CA, USA. 7. Institute for Spine and Scoliosis, Lawrenceville, NJ, USA. 8. Department of Orthopedics, Columbia University, New York, NY, USA. 9. Cooper Bone & Joint Institute, Camden, NJ, USA.
Abstract
STUDY DESIGN: Prospective registry. The evolution of spinal instrumentation has provided better outcomes in adolescent idiopathic scoliosis (AIS); however, there is a paucity of reliable prospective information on 10-year post-operative outcomes of modern surgical techniques. METHODS: A prospective multicenter registry of patients who had surgical correction of AIS was reviewed. Patients with major thoracic scoliosis (Lenke types 1-4) operated on between 1997 and 2007, with 10-year post-operative follow-up data were included. Radiographic and clinical outcomes including Scoliosis Research Society (SRS)-22 scores and revision surgeries were evaluated. RESULTS: One hundred and seventy-four patients (mean 25.0 years of age at most recent evaluation) were included. Pedicle screw constructs were used in 102 patients (58%), hook or hybrid constructs in 22 (13%), and anterior screw-rod constructs in 50 (29%). The mean pre-operative thoracic Cobb angle was corrected from 53° to 18° initially. At 10-year follow-up, the mean thoracic curve was 22° (mean 57% correction), with 29 patients (16.7%) having loss of correction (LOC) ≥ 10°. There were a total of 14 revision surgeries performed in 13 patients (7.5%). SRS-22 pain (p = 0.035), self-image (p < 0.001), and total scores (p < 0.001) significantly improved at 2-year follow-up. The mean pain score at 10-year follow-up was similar to pre-operative scores and lower (more pain) than previously published mean scores of normal adults aged 20-40 years (p < 0.05). CONCLUSIONS: Spinal fusion patients report SRS-22 quality of life 10 years after scoliosis surgery that is minimally reduced compared to healthy peers and substantially better than an un-operated cohort of comparably aged scoliosis patients. Adolescents with thoracic idiopathic scoliosis should expect little if any change in their health-related quality of life compared to before surgery, high satisfaction, and a 7.5% chance of revision surgery 10 years after their index spinal fusion. LEVEL OF EVIDENCE: Therapeutic II.
STUDY DESIGN: Prospective registry. The evolution of spinal instrumentation has provided better outcomes in adolescent idiopathic scoliosis (AIS); however, there is a paucity of reliable prospective information on 10-year post-operative outcomes of modern surgical techniques. METHODS: A prospective multicenter registry of patients who had surgical correction of AIS was reviewed. Patients with major thoracic scoliosis (Lenke types 1-4) operated on between 1997 and 2007, with 10-year post-operative follow-up data were included. Radiographic and clinical outcomes including Scoliosis Research Society (SRS)-22 scores and revision surgeries were evaluated. RESULTS: One hundred and seventy-four patients (mean 25.0 years of age at most recent evaluation) were included. Pedicle screw constructs were used in 102 patients (58%), hook or hybrid constructs in 22 (13%), and anterior screw-rod constructs in 50 (29%). The mean pre-operative thoracic Cobb angle was corrected from 53° to 18° initially. At 10-year follow-up, the mean thoracic curve was 22° (mean 57% correction), with 29 patients (16.7%) having loss of correction (LOC) ≥ 10°. There were a total of 14 revision surgeries performed in 13 patients (7.5%). SRS-22 pain (p = 0.035), self-image (p < 0.001), and total scores (p < 0.001) significantly improved at 2-year follow-up. The mean pain score at 10-year follow-up was similar to pre-operative scores and lower (more pain) than previously published mean scores of normal adults aged 20-40 years (p < 0.05). CONCLUSIONS: Spinal fusion patients report SRS-22 quality of life 10 years after scoliosis surgery that is minimally reduced compared to healthy peers and substantially better than an un-operated cohort of comparably aged scoliosispatients. Adolescents with thoracic idiopathic scoliosis should expect little if any change in their health-related quality of life compared to before surgery, high satisfaction, and a 7.5% chance of revision surgery 10 years after their index spinal fusion. LEVEL OF EVIDENCE: Therapeutic II.
Authors: Arun R Hariharan; Suken A Shah; Joseph Petfield; Margaret Baldwin; Burt Yaszay; Peter O Newton; Lawrence G Lenke; Baron S Lonner; Firoz Miyanji; Paul D Sponseller; Amer F Samdani Journal: Spine Deform Date: 2022-04-30