Back Pain and Quality of Life 10 Years After Segmental Pedicle Screw Instrumentation for Adolescent Idiopathic Scoliosis

• Published in: Spine (Philadelphia, Pa. 1976) Pa. 1976), 2023-05, Vol.48 (10), p.665-671
• Main Authors: Ahonen, Matti, Syvänen, Johanna, Helenius, Linda, Mattila, Mikko, Perokorpi, Tanja, Diarbakerli, Elias, Gerdhem, Paul, Helenius, Ilkka
• Format: Article
• Language: English
• Subjects: Adolescent; adolescent idiopathic scoliosis; Back Pain - etiology; Cohort Studies; Follow-Up Studies; fusion level; health-related quality of life; healthy controls; Humans; Kyphosis - etiology; Medicin och hälsovetenskap; pedicle screw instrumentation; Pedicle Screws; posterior spinal fusion; Quality of Life; Retrospective Studies; Scoliosis - diagnostic imaging; Scoliosis - etiology; Scoliosis - surgery; Spinal Fusion - methods; Treatment Outcome; untreated patients
• ISSN: 0362-2436; 1528-1159; 1528-1159
• DOI: 10.1097/BRS.0000000000004641

Comparative cohort study. The aim of the present study was to evaluate pain and health-related quality of life (HRQoL) in surgically managed patients with a minimum follow-up of 10 years compared with patients with untreated adolescent idiopathic scoliosis (AIS) and a healthy control group. Posterior spinal fusion with pedicle screws is the standard treatment for AIS, although it remains unclear whether this procedure results in improved long-term HRQoL compared with untreated patients with AIS. Sixty-four consecutive patients at a minimum follow-up of 10 years, who underwent posterior pedicle screw instrumentation for AIS were prospectively enrolled. Fifty-three (83%) of these patients completed Scoliosis Research Society (SRS) 24 questionnaires, clinical examination, and standing spinal radiographs. Pain and HRQoL were compared with age and sex-matched patients with untreated AIS and healthy individuals. The mean major curve was 57° preoperatively and 15° at the 10-year follow-up. SRS-24 self-image domain score showed a significant improvement from preoperative to 2 years and remained significantly better at the 10-year follow-up ( P < 0.001). Patients fused to L3 or below had lower pain, satisfaction, and total score than patients fused to L2 or above ( P < 0.05), but self-image, function, and activity scores did not differ between groups at 10-year follow-up. Pain, self-image, general activity, and total SRS domains were significantly better at 10-year follow-up in the surgically treated patients as compared with untreated patients (all P < 0.05). Healthy controls had significantly higher total score s than those surgically treated at 10-year follow-ups ( P < 0.001). Patients undergoing segmental pedicle screw instrumentation for AIS maintain high-level HRQoL during a 10-year follow-up. Their HRQoL was significantly better than in the untreated patients with AIS, except for the function domain. However, HRQoL remained at a lower level than in healthy controls.