Resumo

BLANKSON, Benjamin H; NOCONJO, Lubabalo  e  DUNN, Robert N. Radiographic and clinical outcomes in adolescent idiopathic scoliosis corrective fusion surgery: a one-year follow-up. SA orthop. j. [online]. 2024, vol.23, n.3, pp.128-133. ISSN 2309-8309.  https://doi.org/10.17159/2309-8309/2024/v23n3a3.

BACKGROUND: Adolescent idiopathic scoliosis (AIS) is a complex three-dimensional deformity of the spine, characterised by a coronal Cobb angle of at least ten degrees. The goal of surgery is not only to prevent progression, but restoration of sagittal and coronal balance, protection of cardiopulmonary function, and improvement of cosmesis. In this study, we reviewed the impact of deformity correction surgery in terms of radiology and patient-reported outcomes. METHOD: Data extracted from a prospectively maintained database (2003-2022) was retrospectively analysed for pre- and postoperative patient-reported outcome measures (PROMs), captured using the Scoliosis Research Society-22 (sRS-22) questionnaire, as well as radiological parameters. Forty-four patients with AIS were identified with pre- and postoperative PROMs. The average age at surgery was 15 years, with 84% female. There were 38% with Lenke 1 curves, and three patients had Lenke 6 curves. Posterior approach surgery was used for 73%. RESULTS: There was a total improvement in SRS-22 scores by 8%, with 75% achieving minimum clinically important difference (MCID). Patients reported significant satisfaction with treatment of 4.8 out of 5, and improvement in self-image with a change of 1.1 (p < 0.05). However, no difference in function and pain were recorded (p > 0.05). Overall, proximal thoracic (PT) curves improved from 24-11° (p < 0.05), main thoracic (MT) curves from 55-19° (p < 0.05), and thoracolumbar/lumbar (TL/L) curves from 45-11° (p < 0.05). Preoperative flexibility and postoperative correction for PT curves were 40% and 41%, respectively. MT was 32% and 67%, while that for TL/L was 57% and 71%, respectively. CONCLUSION: Surgery yields significant main curve correction, which corresponds to high patient-reported satisfaction rate. Although the total SRS-22 score yielded an 8% improvement, subanalysis of self-image showed the most significant improvement of 4.5/5 (p < 0.05). Level of evidence: Level 3

Palavras-chave : adolescent idiopathic scoliosis; quality of life; SRS-22; anterior and posterior fusion; South Africa.

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