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Radiological Outcomes in Adolescent Idiopathic Scoliosis Patients More Than 22 Years After Treatment

  • Long-Term Follow-Up Case Series
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Abstract

Study Design

Longitudinal cohort.

Objectives

To evaluate the long-term radiologic outcomes in adolescent idiopathic scoliosis (AIS) patients more than 22 years after treatment.

Summary of Background Data

Although treatment for AIS is prophylactic and is aimed at preventing curve progression, very few studies report long-term outcomes of treatment.

Methods

AIS patients treated with Boston brace or posterior spinal fusion (PSF) with Harrington-dorso-transverse traction (DTT) instrumentation from 1983 to 1990 were requested to return to clinic. Subsequently, 36-inch standing radiographs were obtained after patient consent. Cobb angles were compared with pretreatment and immediate posttreatment radiographs. Any evidence of adjacent-level disease or local kyphosis was also noted.

Results

One hundred fifty-nine (78%) of 219 patients were available for follow-up, 66 braced and 93 surgical. There were 85 females with an average age at surgery of 14. 3 years and an average age at follow-up of 37. 6 years. The mean length of follow-up was 24. 5 years (range, 22-30 years). There was a statistically significant curve progression of 2. 9° in the PSF group. There was a greater degree of curve progression in the braced group (5. 5°), but this was not statistically significant. Proximal segment degeneration was seen in 8 (5%), 2 in the brace cohort and 6 in the PSF cohort. Distal segment degeneration was seen in 26 (16%) patients, 4 treated with brace and 22 treated with PSF. No patient developed proximal junction kyphosis. Three patients in the PSF cohort required additional surgery for distal adding-on. Four patients had a noncontiguous L5-SI fusion, three from the PSF cohort and one from the braced cohort.

Conclusion

In this cohort with an average follow-up of 24. 5 years, with 78% available for follow-up, both the braced and surgically treated patients had a very small degree of curve progression, with a small incidence of distal segment degeneration and reoperation.

Level of Evidence

III.

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References

  1. Lonstein JE, Bjorklund S, Wanninger MH, Nelson RP. Voluntary school screening for scoliosis in Minnesota. J Bone Joint Surg Am 1982;2:481–8.

    Article  Google Scholar 

  2. Andersen MO, Kyvik K, Thomsen K. Adolescent idiopathic scoliosis in twins, a population based survey. Spine 2010;2:1571–4.

    Article  Google Scholar 

  3. Danielsson AJ. Natural history of adolescent idiopathic scoliosis: a tool for guidance in decision of surgery of curves above 50°. J Child Orthop 2013;2:37–41.

    Article  Google Scholar 

  4. Weinstein SL, Dolan LA, Wright JG, et al. Effect of bracing in adolescent with idiopathic scoliosis. N Engl J Med 2013;2:1512–21.

    Article  Google Scholar 

  5. Danielsson AJ, Nachemson AL. Back pain and function 22 years after brace treatment for adolescent idiopathic scoliosis: a case-control study-part I. Spine (Phila Pa 1976) 2003;2:2078–85.

    Article  Google Scholar 

  6. Risser JC. The iliac apophysis; an invaluable sign in the management of scoliosis. Clin Orthop 1958;2:111–9.

    Google Scholar 

  7. Reem J, Carney J, Stanley M, Cassidy J. Risser sign inter-rater and intra-rater agreement: is the Risser sign reliable? Skeletal Radiol 2009;2:371–5.

    Article  Google Scholar 

  8. Mariconda M, Galasso O, Barca P, et al. Minimum 20-year follow-up results of Harrington rod fusion for idiopathic scoliosis. Eur Spine J 2005;2:854–61.

    Article  Google Scholar 

  9. Niemeyer T, Bovingloh AS, Grieb S, et al. Low back pain after spinal fusion and Harrington instrumentation for idiopathic scoliosis. Int J Orthop 2005;2:47–50.

    Article  Google Scholar 

  10. Helenius I, Remes V, Yrjonen T, et al. Comparison of long-term function and radiological outcomes after Harrington instrumentation and spondylodesis in adolescent idiopathic scoliosis: a review of 78 patients. Spine 2002;15(27):176–80.

    Article  Google Scholar 

  11. Paonessa KJ, Engler GL. Back pain and disability after Harrington rod fusion to the lumbar spine for scoliosis. Spine (Phila Pa 1976) 1992;17(8 suppl):S249–53.

    Article  CAS  Google Scholar 

  12. Danielsson AJ, Nachemson AL. Back pain and function 23 years after fusion for adolescent idiopathic scoliosis: a case-control study-part II. Spine (Phila Pa 1976) 2003;28:E373–83.

    Article  Google Scholar 

  13. Glattes RC, Bridwell KH, Lenke LG, et al. Proximal junctional kyphosis in adult spinal deformity following long instrumented posterior spinal fusion: incidence, outcomes, and risk factor analysis. Spine (Phila Pa 1976) 2005;2:1643–9.

    Article  Google Scholar 

  14. Kuklo TR, Potter BK, Schroeder TM, et al. Comparison of manual and digital measurements in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2006;2:1240–6.

    Article  Google Scholar 

  15. Andersen GR, Andersen MO, Christensen SB. Selection of fusion levels in idiopathic scoliosis treated by Harrington-DTT instrumentation: a short term radiologic study. J Pediatr Orthop B 1995;2:86–90.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Center for Spine Research and Surgery, Lillebaelt Hospital, Ostre Hougvej 55, DK-5500, Middelfart, Denmark

    Ane Simony MD, Steen Bach Christensen DrMed, Leah Y. Carreon MD, MSc & Mikkel Osterheden Andersen MD

  2. Department of Orthopaedic Surgery, University Hospital - Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark

    Steen Bach Christensen DrMed

Authors
  1. Ane Simony MD
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  2. Steen Bach Christensen DrMed
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  3. Leah Y. Carreon MD, MSc
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  4. Mikkel Osterheden Andersen MD
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Corresponding author

Correspondence to Ane Simony MD.

Additional information

This study was approved by the Ethical Committee of Southern Denmark, Datatilsynet and was conducted at the Section for Spine Surgery and Research, Lillebaelt Hospital, Ostre Hougvej 55, 5000 Middelfart, Denmark.

This study was funded by the Danish Rheumatism Association, Fonden af 17-12-1981, Erik Birger Christensen Fund and AP Møllers Fund.

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Simony, A., Christensen, S.B., Carreon, L.Y. et al. Radiological Outcomes in Adolescent Idiopathic Scoliosis Patients More Than 22 Years After Treatment. Spine Deform 3, 436–439 (2015). https://doi.org/10.1016/j.jspd.2015.03.003

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  • DOI: https://doi.org/10.1016/j.jspd.2015.03.003

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