This was a systematic review and meta-analysis
This study aims to perform a systematic review and quantitative meta-analysis
of patient-reported outcome
measures after spinal fusion
for adolescent idiopathic scoliosis
Summary of Background Data:
Radiographic correction of scoliosis
is extensively reported in the literature but there is a need to study the impact of spinal fusion
on patient-reported outcome
measures. Prior reviews lacked homogeneity in outcome measures, did not perform quantitative meta-analysis
of pooled effect size
, or interpret the results in light of minimally clinically important difference thresholds.
Materials and Methods:
A systematic review of medical databases identified all studies that prospectively reported Scoliosis
Research Society (SRS
)-22 questionnaire data after spinal fusion
. We screened 2314 studies for eligibility. Studies were included that reported preoperative and postoperative data at 24- or >60-month follow-up. Studies were excluded that failed to report means and SDs which were needed to calculate Cohen d
effect sizes and 95% confidence intervals in estimating the magnitude and precision of the effect.
A total of 7 studies met eligibility criteria for inclusion in quantitative meta-analysis
of effect sizes and 95% confidence intervals. Patients report large improvements in total score, self-image, and satisfaction; and moderate improvements in pain, function and mental health at 2 and 5 years after spinal fusion
. All domains showed statistically significant improvement at all times except function at >60 months. All domains surpassed the minimally clinically important difference at all times except mental health.
Moderate evidence suggests that spinal fusion
improves quality of life for adolescents with idiopathic scoliosis
in medium and long-term follow-up. Our results may help inform patient expectations regarding surgery.
OCEMB Level of Evidence:
Level I—systematic review and meta-analysis
of prospective studies.