Influence of pre-operative disease course on operation and post-operative quality of life in adolescents with idiopathic scoliosis / 第二军医大学学报

ABSTRACT

Objective: To study the influence of pre-operative disease course on the operation and post-operation quality of life of adolescents with idiopathic scoliosis (AIS). Methods: A total of 110 AIS patients who were treated with classic posterior correction, pedicle internal fixation were divided into two groups according to their disease courses (n=55) short course group with a pre-operation course <2 years (S group), long course group with a pre-operation course ≥2 years (L group). The gender, Lenke type, and major curve Cobb angle were matchable between the two groups. Various radiographic measurements and indices like fusion level, intraoperative blood loss and scores of SRS-22 scale were compared between the two groups before operation, immediately, and 2 years after operation. Results: The pre-operative Cobb angles of the major curve were similar between the two groups, but the flexibility of the major curve averaged (55.7±18.77)% in the S group and (48.1±18.24)% in the L group (P = 0.034). Pre-operative Cobb angles of the minor curve were larger in L group than those in S group ([30.1±12.10]° in the S group and [34.8±10.85]° in the L group, P = 0.035). The post-operative radiographic measurements and the blood loss/infusion were similar between the two groups. The number of fused vertebrae in the L group was significantly more than that in the S group (P = 0.027). The parameters in the SRS-22 scale, including function/activity, pain, self-image/appearance, and mental health were similar between the two groups during follow-up. And the L group had a significantly lower satisfaction rate of treatment compared with the S group ([4.0±0.70] vs [3. 7±0.78], P = 0.037). Conclusion: The flexibility of the curve in AIS decreases with the increase of disease course, and the disease course might be a risk factor for the scoliosis progression of the minor side. Patients with a disease course ≥2 years have more fused vertebrae than those with a disease course <2 years. The length of pre-operative disease course has influence on the quality of life of AIS patients after operation.