Children (Feb 2023)

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

  • Pawel Grabala,
  • Ilkka J. Helenius,
  • Jacob M. Buchowski,
  • Suken A. Shah

DOI
https://doi.org/10.3390/children10020299
Journal volume & issue
Vol. 10, no. 2
p. 299

Abstract

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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%) (p p p < 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.

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