The Efficacy of a Posterior Approach to Surgical Correction for Neglected Idiopathic Scoliosis: A Comparative Analysis According to Health-Related Quality of Life, Pulmonary Function, Back Pain and Sexual Function

Overview

Journal Children (Basel)

Specialty Health Services

Date 2023 Feb 25

PMID 36832428

Authors

Pawel Grabala

Ilkka J Helenius

Jacob M Buchowski

Suken A Shah

Affiliations

Soon will be listed here.

Abstract

Background: This study aimed to evaluate the treatment outcomes of severe idiopathic scoliosis (IS) and hypothesized that surgical treatment would have a superior impact on the health-related quality of life (HRQoL), pulmonary function (PF), back pain, and sexual function.

Methods: We retrospectively reviewed 195 consecutive patients with IS classified into severe (SG) and moderate groups (MG) with a minimum follow-up of two years.

Results: The mean preoperative curve was 131° and 60° in the SG and MG, respectively. The mean preoperative flexibility in the bending films averaged between 22% in the SG and 41% in the MG. After definitive surgery, the main curve was corrected to 61° and 18° in the SG and MG, respectively. The mean preoperative thoracic kyphosis was 83° in the SG and 25° in the MG, which was corrected to 35° in the SG and 25° in the MG. At baseline, the percentage of predicted lung volume (FVC) was significantly lower in the SG than that in the MG (51.2% vs. 83%). The baseline percentage of the predicted FEV1 values was also significantly lower in the SG than in the MG (60.8% vs. 77%). During the two-year follow-up, the percentage of predicted FVC showed significant improvement in the SG (69.9%) ( < 0.001), and the percentage of predicted FEV1 values during the follow-up improved significantly in the SG (76.9%) ( < 0.001) compared with the MG (81%), with no statistical difference observed during the two-year follow-up. The SRS-22r showed a clinically and statistically significant improvement in the preoperative results to those of the final follow-up ( < 0.001).

Conclusions: Surgical treatment of severe scoliosis can be safe. It provided a mean correction of the deformity for 59% of patients and significantly improved respiratory function, with the percentage of predicted forced expiratory volume in 1 s improving by 60% and the forced vital capacity improving by 50%, resulting in clinically and statistically significant improvements in the SRS-22r, HRQoL outcome scores, and back pain (reduced from 36% to 8%), as well as improved sexual function. The planned surgical treatment can achieve a very significant deformity correction with a minimal risk of complications. The surgical treatment has a superior impact on the quality of life patients with severe spinal deformities and significantly improves function in every sphere of life.

Citing Articles

Surgical Treatment Strategies for Severe and Neglected Spinal Deformities in Children and Adolescents without the Use of Radical Three-Column Osteotomies.

Grabala P, Gregorczyk J, Fani N, Galgano M, Grabala M J Clin Med. 2024; 13(16).

PMID: 39200966 PMC: 11355333. DOI: 10.3390/jcm13164824.

From Rib Hump to Baby Hump-Common Questions of Patients Suffering from and Undergoing Treatment for Scoliosis-A Comprehensive Literature Review.

Grabala P, Kowalski P, Grabala M J Clin Med. 2024; 13(13).

PMID: 38999380 PMC: 11242321. DOI: 10.3390/jcm13133814.

Posterior-Only T11 Vertebral Column Resection for Pediatric Congenital Kyphosis Surgical Correction.

Grabala P, Fani N, Gregorczyk J, Grabala M Medicina (Kaunas). 2024; 60(6).

PMID: 38929517 PMC: 11206005. DOI: 10.3390/medicina60060897.

Results of the Surgical Approach of Idiopathic Scoliosis in Adolescents and Postoperative Quality of Life: Systematic Literature Review.

Oliveira B, Moura T, Monte G, Souza B, Borduchi L, Silva L Rev Bras Ortop (Sao Paulo). 2024; 59(3):e358-e363.

PMID: 38911885 PMC: 11193578. DOI: 10.1055/s-0044-1785658.

Radiological and Pulmonary Results of Surgical Treatment of Severe Idiopathic Scoliosis Using Preoperative Halo Gravity Traction Compared with Less Invasive Temporary Internal Distraction in Staged Surgery in Adolescents.

Grabala P, Galgano M, Grabala M, Buchowski J J Clin Med. 2024; 13(10).

PMID: 38792417 PMC: 11122294. DOI: 10.3390/jcm13102875.

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