Comparable satisfaction and clinical outcomes after surgery for adolescent idiopathic scoliosis in the adult (AISA) between the US and Japan.

ABSTRACT

BACKGROUND: The impact of ethnicity on the surgery outcomes of adolescent idiopathic scoliosis in the adult (AISA) is poorly understood. This study aimed to compare the surgery outcomes for AISA between the United States (US) and Japan (JP). METHODS: 171 surgically treated AISA (20-40y) were consecutively collected from 2 separate multicenter databases. Patients were propensity-score matched for age, gender, curve type, levels fused, and 2y postop spinal alignment. Demographic and radiographic parameters were compared between the US and JP at baseline and 2y post-op. RESULTS: A total of 108 patients were matched by propensity score (age; US vs. JP 29 ± 6 vs. 29 ± 7y, females 76 vs. 76%, curve type [Schwab-SRS TypeT; TypeD; TypeL; TypeN] 35; 35; 30; 0 vs. 37; 33; 30; 0%)] levels fused 10 ± 4 vs. 10 ± 4, 2y thoracic curve17 ± 13 vs. 17 ± 12°, 2y CSVL 10 ± 8 vs. 11 ± 9 mm). Similar clinical improvement was achieved between US and JP (function; 4.2 ± 0.9 vs 4.3 ± 0.6, p = 0.60, pain; 3.8 ± 0.9 vs 4.1 ± 0.8, p = 0.13, satisfaction; 4.3 ± 0.9 vs 4.2 ± 0.7, p = 0.61, total; 4.0 ± 0.8 vs 4.1 ± 0.5, p = 0.60). The correlation analyzes indicated that postoperative SRS-22 subdomains correlated differently with satisfaction (all subdomains moderately correlated with satisfaction in the US while only pain and mental health correlated moderately with satisfaction in JP ([function r = 0.61 vs 0.29, pain r = . 72 vs 0.54, self-image r = 0.72 vs 0.37, mental health r = 0.64 vs 0.55]). CONCLUSIONS: Surgery for AISA was similarly effective in the US and JP. Satisfaction for spinal surgery among patients in different countries may not be different unless the procedure limits an individual's unique lifestyle that the patient expected to resume.