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Minimum 20-Year Health-Related Quality of Life and Surgical Rates After the Treatment of Adolescent Idiopathic Scoliosis

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Abstract

Study Design

Longitudinal cohort.

Objectives

To determine the patient-reported functional outcomes and need for related surgical procedures in a US cohort of adolescent idiopathic scoliosis (AIS) patients with minimum 20-year follow-up.

Summary of Background Data

There is limited information regarding the long-term outcomes of scoliosis treatment in the US population.

Methods

A novel population of patients who underwent pediatric treatment for AIS with minimum 20-year follow-up was identified. Search of a single-center diagnostic registry generated 337 patients who fulfilled the inclusion criteria (AIS, curve magnitude >35°, and childhood treatment with bracing, surgery, or observation from 1975 to 1992). Any additional spine surgery as well as EQ5D, ODI, SRS 22, SAQ were determined. A total of 180 patients were included (mean of 30-year follow-up, range 20–37). Childhood treatment entailed bracing (41 patients), surgery (103 patients), and observation (36 patients).

Results

During the study period, only 1 of the 41 bracing patients underwent additional scoliosis-related spine surgery, whereas 5 of the 36 patients in the observation cohort underwent scoliosis surgery as adults. Seven of 103 childhood surgical patients required additional revision surgery as adults. Fifteen patients (4 braced, 7 fusion, and 4 observed) underwent chest wall surgery as adults. SRS scores were around 10% worse compared to population-based controls, with the exception of SRS mental health scores, which were similar to controls. Overall, 5.6% of patients were on disability, with no difference between operative and nonoperative groups.

Conclusion

We found a low rate of adult scoliosis surgery in the braced population, and a low rate of revision surgery at the 30-year follow-up in patients undergoing spine fusion for AIS between 1975 and 1992. No detected differences in patient-reported outcomes were found between the braced, surgical, and observed populations at a mean of 30 years’ follow-up.

Level of Evidence

Level III, therapeutic.

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Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, 55905, Rochester, MN, USA

    A. Noelle Larson MD, Fady Baky MD, Ali Ashraf MD, Yaser M. Baghdadi MD, Vickie Treder LPN, CCRP & Michael J. Yaszemski MD, PhD

  2. Department of Orthopaedic Surgery, University of Minnesota, 55455, Minneapolis, MN, USA

    David W. Polly Jr MD

Authors
  1. A. Noelle Larson MD
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  2. Fady Baky MD
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  3. Ali Ashraf MD
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  4. Yaser M. Baghdadi MD
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  5. Vickie Treder LPN, CCRP
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  6. David W. Polly Jr MD
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  7. Michael J. Yaszemski MD, PhD
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Corresponding author

Correspondence to A. Noelle Larson MD.

Additional information

Author disclosures: ANL (grants from Scoliosis Research Society, during the conduct of the study; personal fees from K2M and Orthopediatrics, outside the submitted work), FB (none), AA (none), YMB (none), VT (none), DWP (none), MJY (none).

Funding: This study was funded by the Directed Research Grant from the Scoliosis Research Society.

IRB approval: Mayo Clinic IRB: 16-008732 and 12-000004.

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Larson, A.N., Baky, F., Ashraf, A. et al. Minimum 20-Year Health-Related Quality of Life and Surgical Rates After the Treatment of Adolescent Idiopathic Scoliosis. Spine Deform 7, 417–427 (2019). https://doi.org/10.1016/j.jspd.2018.09.003

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  • DOI: https://doi.org/10.1016/j.jspd.2018.09.003

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