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Clinical and radiographic outcomes following correction of idiopathic scoliosis in adolescence vs young adulthood

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Abstract

Purpose

The natural history of adolescent idiopathic scoliosis (AIS) has been well documented, but the impact of age at the time of surgical correction is relatively understudied. In this study, we matched patients undergoing surgical correction of adult idiopathic scoliosis (AdIS) with a cohort of AIS patients to compare: (1) coronal and sagittal radiographic correction, (2) operative variables, and (3) postoperative complications.

Methods

A single-institution scoliosis registry was queried for patients undergoing idiopathic scoliosis surgery from 2000–2017. Inclusion criteria: patients with idiopathic scoliosis, no previous spine surgery, and 2-year follow-up. AdIS patients were matched 1:2 with AIS patients based on Lenke classification and curve characteristics. Independent sample t-test and Chi-square test was used to analyze the data.

Results

31 adults underwent surgical correction of idiopathic scoliosis and were matched with 62 adolescents. Mean age of adults was 26.2 ± 11.05, mean BMI was 25.6 ± 6.0, and 22 (71.0%) were female. Mean age of adolescents was 14.2 ± 1.8, mean BMI was 22.7 ± 5.7, and 41(66.7%) were female. AdIS had significantly less postoperative major Cobb correction (63.9% vs 71.3%, p = 0.006) and final major Cobb correction (60.6% vs 67.9%, p = 0.025). AdIS also had significantly greater postoperative T1PA (11.8 vs 5.8, p = 0.002). AdIS had longer operative times (p = 0.003), higher amounts of pRBCs transfused (p = 0.005), longer LOS (p = 0.016), more ICU requirement (p = 0.013), higher overall complications (p < 0.001), higher rate of pseudarthrosis (p = 0.026), and more neurologic complications (p = 0.013).

Conclusion

Adult patients undergoing surgical correction of idiopathic scoliosis had significantly worse postoperative coronal and sagittal alignment when compared with adolescent patients. Adult patients also had higher rates of complications, longer operative times, and longer hospital stays.

Level of evidence: III.

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Funding

This study did not receive funding from any institution or grant.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Vanderbilt University Medical Center, 1215 21St Ave S, South Tower, Suite #4200, Nashville, TN, 37232, USA

    Matthew E. LaBarge, William H. Waddell, Justin Vickery, Andrew J. Croft, Amir M. Abtahi, Craig R. Louer, Jeffrey E. Martus, Gregory A. Mencio, Scott L. Zuckerman & Byron F. Stephens

  2. Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA

    Hani Chanbour, Soren Jonzzon, Steven G. Roth, Amir M. Abtahi, Scott L. Zuckerman & Byron F. Stephens

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  1. Matthew E. LaBarge
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Contributions

MELB: Data curation, drafting the paper, final approval of the version to be published, contributed effort to the study. HC: Data curation, formal analysis, final approval of the version to be published, contributed effort to the study. WHW: Data curation, interpretation of the analysis, final approval of the version to be published, contributed effort to the study. JV: Data curation, interpretation of the analysis, final approval of the version to be published, contributed effort to the study. SJ: Data curation, drafting the paper, final approval of the version to be published, contributed effort to the study. SGR: Design and execution of the formal analysis, final approval of the version to be published, contributed effort to the study. AJC: Data curation, revisions, final approval of the version to be published, contributed effort to the study. AMA: Conducted review and editing, final approval of the version to be published, contributed effort to the study. CRL: Design and execution of the formal analysis, final approval of the version to be published, contributed effort to the study. JEM: Design and execution of the formal analysis, final approval of the version to be published, contributed effort to the study. GAM: Design and execution of the formal analysis, final approval of the version to be published, contributed effort to the study. SLZ: Designed research, data acquisition, conceptualization, interpretation of the analysis, final approval of the version to be published, contributed effort to the study. BFS: Conducted review and editing, final approval of the version to be published, contributed effort to the study.

Corresponding author

Correspondence to Byron F. Stephens.

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Conflict of interest

BFS—research support: Stryker Spine. All the authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper. The authors have no personal or institutional financial interest in drugs, materials, or devices described in their submissions.

Ethical approval

This study was approved by the IRB committee at Vanderbilt University Medical Center (IRB# 211700). We certify that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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LaBarge, M.E., Chanbour, H., Waddell, W.H. et al. Clinical and radiographic outcomes following correction of idiopathic scoliosis in adolescence vs young adulthood. Spine Deform 11, 1443–1451 (2023). https://doi.org/10.1007/s43390-023-00708-8

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