Correlation of radiographic parameters and patient satisfaction in adolescent idiopathic scoliosis treated with posterior screw-dual-rod instrumentation

PurposeIn surgical treatment of adolescent idiopathic scoliosis (AIS), only a few studies measure both, radiological parameters and PROMs and correlate them.MethodsProspectively collected AIS-data of one scoliosis-center within a multicenter German-Spine-Society-Study. All patients underwent instrumented posterior spinal correction and fusion with pedicle-screw-dual-rod-systems from 05/2019 to 01/2021. The data were retrospectively analyzed. Inclusion criteria: age 11-17 years, follow-up (FU) at least 12 months. Clinical data, radiographic parameters, and PROMs (SRS-30-questionnaire) were collected. 100% of patients had X-ray images, 88.2% completed SRS-30. Parameters were given as mean & PLUSMN; SD. Differences and subdivision by lower instrumented vertebra (LIV) were analyzed by students t-test (significancy a = 0.05), associations by Pearson's correlation.ResultTotal of 51 patients: 15 & PLUSMN; 1.4 years, BMI 20.7 & PLUSMN; 3.7 kg/m(2), FU 16.6 & PLUSMN; 6.1 months, fusion length 9.2 & PLUSMN; 2.3 segments, implant density 93 & PLUSMN; 9%, surgical time 215 & PLUSMN; 71 min, mean blood loss 504 & PLUSMN; 360 ml. Mean preoperative Cobb angle of main curve 64 & PLUSMN; 14 & DEG;, of secondary main curve 46 & PLUSMN; 12 & DEG;, corrected by 68 & PLUSMN; 11%, 56 & PLUSMN; 17%, respectively. Mean thoracic rib and lumbar hump significantly decreased by - 8.5 & PLUSMN; 7.0 & DEG; and - 7.7 & PLUSMN; 8.9 & DEG; (p < 0.5). High thoracic rib hump almost unchanged, - 0.4 & PLUSMN; 2.8 & DEG; (p = 0.3). Thoracic kyphosis (- 0.9 & PLUSMN; 12.8 & DEG;, p = 0.6), lumbar lordosis (1.5 & PLUSMN; 10.1 & DEG;, p = 0.3), clavicle angle (- 0.5 & PLUSMN; 2.7 & DEG;) and spinopelvic parameters (p > 0.5) did not significantly change, only LIV-tilt from 24.5 & PLUSMN; 6.7 & DEG; to 6.5 & PLUSMN; 4.3 & DEG; (p < 0.05). PROMs significantly improved (p < 0.05), no significant improvement for function/activity (p = 0.4). Preoperative mean total-score was 3.6 & PLUSMN; 0.5, 4.2 & PLUSMN; 0.3 at FU(p < 0.05). Self-image improved in 67%. Moderately strong correlation for PROMs: the better LIV-tilt (r = - 0.5) correction and the shorter surgery time (r = - 0.4), the better SRS-30 total-score. No correlation for curve correction and patient's satisfaction.ConclusionIn summary, results of this study demonstrate good surgical correction and significant improvement of most PROMs.

Automated summary

The purpose of this study was to measure both radiological parameters and patient-reported outcome measures (PROMs) in adolescent idiopathic scoliosis (AIS) patients and analyze their correlation. The results showed that surgical treatment can effectively correct scoliosis and significantly improve patient-reported outcomes.