Clinical and radiographic outcomes following correction of idiopathic scoliosis in adolescence vs young adulthood

Matthew E LaBarge; Hani Chanbour; William H Waddell; Justin Vickery; Soren Jonzzon; Steven G Roth; Andrew J Croft; Amir M Abtahi; Craig R Louer; Jeffrey E Martus; Gregory A Mencio; Scott L Zuckerman; Byron F Stephens

doi:10.1007/s43390-023-00708-8

Clinical and radiographic outcomes following correction of idiopathic scoliosis in adolescence vs young adulthood

Spine Deform. 2023 Nov;11(6):1443-1451. doi: 10.1007/s43390-023-00708-8. Epub 2023 Jul 11.

Authors

Affiliations

¹ Department of Orthopaedic Surgery, Vanderbilt University Medical Center, 1215 21St Ave S, South Tower, Suite #4200, Nashville, TN, 37232, USA.
² Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
³ Department of Orthopaedic Surgery, Vanderbilt University Medical Center, 1215 21St Ave S, South Tower, Suite #4200, Nashville, TN, 37232, USA. byron.stephens@vumc.org.
⁴ Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA. byron.stephens@vumc.org.

PMID: 37433979
DOI: 10.1007/s43390-023-00708-8

Abstract

Purpose: The natural history of adolescent idiopathic scoliosis (AIS) has been well documented, but the impact of age at the time of surgical correction is relatively understudied. In this study, we matched patients undergoing surgical correction of adult idiopathic scoliosis (AdIS) with a cohort of AIS patients to compare: (1) coronal and sagittal radiographic correction, (2) operative variables, and (3) postoperative complications.

Methods: A single-institution scoliosis registry was queried for patients undergoing idiopathic scoliosis surgery from 2000-2017.

Inclusion criteria: patients with idiopathic scoliosis, no previous spine surgery, and 2-year follow-up. AdIS patients were matched 1:2 with AIS patients based on Lenke classification and curve characteristics. Independent sample t-test and Chi-square test was used to analyze the data.

Results: 31 adults underwent surgical correction of idiopathic scoliosis and were matched with 62 adolescents. Mean age of adults was 26.2 ± 11.05, mean BMI was 25.6 ± 6.0, and 22 (71.0%) were female. Mean age of adolescents was 14.2 ± 1.8, mean BMI was 22.7 ± 5.7, and 41(66.7%) were female. AdIS had significantly less postoperative major Cobb correction (63.9% vs 71.3%, p = 0.006) and final major Cobb correction (60.6% vs 67.9%, p = 0.025). AdIS also had significantly greater postoperative T1PA (11.8 vs 5.8, p = 0.002). AdIS had longer operative times (p = 0.003), higher amounts of pRBCs transfused (p = 0.005), longer LOS (p = 0.016), more ICU requirement (p = 0.013), higher overall complications (p < 0.001), higher rate of pseudarthrosis (p = 0.026), and more neurologic complications (p = 0.013).

Conclusion: Adult patients undergoing surgical correction of idiopathic scoliosis had significantly worse postoperative coronal and sagittal alignment when compared with adolescent patients. Adult patients also had higher rates of complications, longer operative times, and longer hospital stays.

Level of evidence: III.

Keywords: Adolescent idiopathic scoliosis; Adult idiopathic scoliosis; Adult spinal deformity; Radiographic outcomes.