Adolescent idiopathic scoliosis (AIS) is the most common form of idiopathic scoliosis, and surgery is considered as one of the therapeutic options. However, it is associated with a variety of irreversible complications, in spite of the benefits it provides. Here, we evaluated the long-term outcome of posterior spinal fusion (PSF) of AIS to shed more light on the consequences of this surgery.
In a cross-sectional study, a total of 42 AIS patients who underwent PSF surgery were radiographically and clinically inspected for the potential post-operative complications. Radiographic assessments included the device failure, union status, and vertebral tilt below the site of fusion. Clinical outcomes were evaluated using the Oswestry disability index (ODI) and visual analogue scale (VAS).
The mean age of the surgery was 14.4 ± 5.1 years. The mean follow-up of the patients was 5.6 ± 3.2 years. Complete union was observed in all patients, and no device failure was noticed. Pre- and post-operative vertebral tilt below the site of fusion were 11.12° ± 7.92° and 6.21° ± 5.73°, respectively (p < 0.001). The mean post-operative ODI was 16.7 ± 9.8. The mean post-operative VAS was 2.1 ± 0.7. ODI value was positively correlated with follow-up periods (p = 0.04, r = 0.471). New degenerative disc disease (DDD) was observed in 6 out of 37 (16%) patients.
In spite of the efficacy and safety of PSF surgery of AIS, it might result in irreversible complications such as DDD. Moreover, the amount of post-operative disability might increase over the time and should be discussed with the patients.
Koop S. Infantile and juvenile idiopathic scoliosis. Orthop Clin North Am. 1988;19:331–7. PubMed
Burton MS. Diagnosis and treatment of adolescent idiopathic scoliosis. Pediatr Ann. 2013;42:e233–7. CrossRef
Tari SHV, Mahabadi EA, Ghandehari H, Nikouei F, Javaheri R, Safdari F. Spinopelvic sagittal alignment in patients with adolescent idiopathic scoliosis. Shafa Orthop J. 2015;2(3):e739.
Ghandhari H, Safari MB, Ameri E, Kheirabadi H, Tabrizi A. Correlation curve correction and spinal length gain in patients with adolescent idiopathic scoliosis. J Clin Diagn Res. 2017;11:RC01–4.
Lonner BS, Kondrachov D, Siddiqi F, Hayes V, Scharf C. Thoracoscopic spinal fusion compared with posterior spinal fusion for the treatment of thoracic adolescent idiopathic scoliosis. J Bone Join Surg. 2006;88:1022–34. CrossRef
Viviani G, Raducan V, Bednar D, Grandwilewski W. Anterior and posterior spinal fusion: comparison of one-stage and two-stage procedures. Can J Surg. 1993;36:468–73. PubMed
Geck MJ, Rinella A, Hawthorne D, Macagno A, Koester L, Sides B, Bridwell K, Lenke L, Shufflebarger H. Comparison of surgical treatment in Lenke 5C adolescent idiopathic scoliosis: anterior dual rod versus posterior pedicle fixation surgery: a comparison of two practices. Spine. 2009;34:1942–51. CrossRefPubMed
Huitema G, Willems PC, van Rhijn L, Kleijnen J, Shaffrey CI. Anterior versus posterior spinal correction and fusion for adolescent idiopathic scoliosis. Cochrane Libr. 2014. https://doi.org/10.1002/14651858.CD011280.
Khanna AJ. MRI for orthopaedic surgeons. New York: Thieme; 2010.
Hawes M. Impact of spine surgery on signs and symptoms of spinal deformity. Pediatr Rehab. 2006;9:318–39. CrossRef
Buttermann GR, Mullin WJ. Pain and disability correlated with disc degeneration via magnetic resonance imaging in scoliosis patients. Euro Spine J. 2008;17:240–9. CrossRef
Jones M, Badreddine I, Mehta J, Ede MN, Gardner A, Spilsbury J, Marks D. The rate of disc degeneration on MRI in preoperative adolescent idiopathic scoliosis. Spine J. 2017;17:S332. CrossRef
Harding IJ, Charosky S, Vialle R, Chopin DH. Lumbar disc degeneration below a long arthrodesis (performed for scoliosis in adults) to L4 or L5. Euro Spine J. 2008;17:250–4. CrossRef
Green DW, Lawhorne TW III, Widmann RF, Kepler CK, Ahern C, Mintz DN, Rawlins BA, Burke SW, Boachie-Adjei O. Long-term magnetic resonance imaging follow-up demonstrates minimal transitional level lumbar disc degeneration after posterior spine fusion for adolescent idiopathic scoliosis. Spine. 2011;36:1948–54. CrossRefPubMed
- Long-term outcome of posterior spinal fusion for the correction of adolescent idiopathic scoliosis
Milad Haji Agha Bozorgi
- BioMed Central
Neu im Fachgebiet Orthopädie und Unfallchirurgie
Mail Icon II