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Long‐Term Clinical Outcomes of Surgery for Adolescent Idiopathic Scoliosis 21 to 41 Years Later: *Paper #9

Akazawa, Tsutomu MD; Minami, Shohei; Kotani, Toshiaki; Takahashi, Kazuhisa

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Japan

Summary: Surgery had no effects on pain and mental health in middle age AIS patients 31 years later.

Introduction: Several long‐term follow‐up studies of surgically treated adolescent idiopathic scoliosis have been published that report on clinical outcomes for patients who have reached their 20s or 30s. However, clinical outcomes when patients reach middle age remain unknown. The purpose of this study was to determine the clinical outcome for a group of patients surgically treated for adolescent idiopathic scoliosis who have reached middle age.

Methods: Two hundred fifty‐six patients surgically treated for adolescent idiopathic scoliosis (AIS) between 1968 and 1988 were included in this study. All patients were less than 20 years‐old when they underwent surgery. The SRS‐22 Patient Questionnaire and Roland‐Morris Disability Questionnaire (RDQ) were used for evaluating long‐term clinical outcomes. Sixty‐six (25.8%) of the 256 patients answered the questionnaires, comprising 62 females and 4 males with a mean age of 46.0 (range 34‐56) years and a mean follow‐up period of 31.5 (range 21‐41) years. Seventy‐six healthy age‐and sex‐ matched individuals were selected as a control (CTR) group, comprising 71 females and 5 males with a mean age of 46.6 (range 35‐62) years.

Results: The SRS‐22 responses showed that the AIS patients had significantly decreased function (AIS: 4.3±0.6, CTR: 4.7±0.5, p<0.01) and decreased self‐image (AIS: 3.0±0.8, CTR: 3.7±0.5, p<0.01) in comparison with the controls, but they identified no significant differences between the two groups with respect to pain (AIS: 4.3±0.6, CTR: 4.2±0.5, p=0.14) or mental health (AIS: 3.9±0.9, CTR: 3.7±0.7, p=0.14). The RDQ responses showed that back pain was not significantly increased in the AIS group compared with the CTR group (AIS: 1.8±3.5, CTR: 1.4±3.1, p=0.36).

Conclusion: Surgery had no demonstrable adverse effects on pain and mental health in these middle age AIS patients 31 years later (on average), but the AIS patients did have significantly lower function and lower self‐image than the age‐ and sexmatched healthy controls.

© 2010 Lippincott Williams & Wilkins, Inc.

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