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Comparison of operative implications between adolescent and young adult idiopathic scoliosis patients from scoliosis research society mortality and morbidity database

Abstract

Purpose

To compare the operative implications between adolescent idiopathic scoliosis patients (10–18 years) and young adult idiopathic scoliosis (YAdIS) patients (19–30 years).

Methods

This was a retrospective study querying the SRS M&M database for AIS (10–18 years) and YAdIS (19–30 years) cases enrolled between 2009 and 2015. Demographic and surgical parameters (Lenke curve classification, preoperative curve magnitude, approach type, osteotomy type, estimated blood volume (EBV), levels of fusion and ASA scores) were evaluated and compared between groups.

Results

N = 690: AIS (n = 607) and YAdIS (n = 83). Lenke curve classification distributions in AIS and YAdIS cases were: main thoracic, 293 vs. 34; double thoracic, 42 vs. 5; double major, 159 vs. 15; triple major, 15 vs. 5; thoracolumbar, 85 vs. 17; and lumbar, 5 vs. 6, respectively. Patients with a coronal curve > 90° were significantly greater in YAdIS vs. AIS patients, p = 0.008. Anterior and combined surgery rates were significantly higher in YAdIS, p = 0.028. Two-staged surgeries were significantly higher for YAdIS cohort, p = 0.01. Osteotomy rate was similar between groups, p = 0.42, but proportion of 3-column osteotomies was significantly higher for YAdIS, p < 0.001. ASA (severe systemic disease and some functional limitation) score 3 patients’ rate was higher in YAdIS cohort, p = 0.01. EBV was significantly higher in YAdIS, p = 0.01. Average number of levels of fusions between cohorts was not significant, p = 0.87.

Conclusions

The operative implications observed with young adult idiopathic scoliosis patients may potentially result in more complex surgical procedures and operative-associated complications than their adolescent counterparts. Further studies are required and should include a larger number of cases, be prospective in nature and verifiable data.

Level of evidence

II.

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Availability of data and material

Scoliosis Research Society Morbidity and Mortality Database.

Code availability

Not applicable.

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SK, PD, WFL: made substantial contributions to conception or design; or the acquisition, analysis, or interpretation of data, drafted the work or revised it critically for intellectual content, approved the version to be published, agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to William F. Lavelle.

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Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article. Outside of this manuscript SK: nothing to disclose. PD: nothing to disclose. WFL: research support (money paid to institution) Abryx, AO Foundation, Cerapedics, DePuy Spine, Empirical Spine, Innovasis, Medtronic, Spinal Kinetics, Inc., Vertebral Technologies, Inc.; paid consultant: DePuy Spine, 4-Web, Vertiflex; Stock or Stock Options for 4-Web, Expanding Innovations, Prosydian; Board or committee member receiving no compensation for AAOS, SRS NASS, Innovasis (Scientific Advisory Board), Prosydian (Surgeon Advisory Board); Editorial or governing board for Spine Deformity Journal and SAS.

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Kurra, S., DeMercurio, P. & Lavelle, W.F. Comparison of operative implications between adolescent and young adult idiopathic scoliosis patients from scoliosis research society mortality and morbidity database. Spine Deform 10, 1133–1138 (2022). https://doi.org/10.1007/s43390-022-00515-7

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  • DOI: https://doi.org/10.1007/s43390-022-00515-7

Keywords

  • Adolescent idiopathic scoliosis (AIS)
  • Young adult idiopathic scoliosis (YAdIS)
  • Operative implications