Background
Adolescent idiopathic scoliosis (AIS) is a structural deformity of the spine. Posterior deformity correction represents the gold standard of the surgical treatment of AIS. The fixation technique was shifted from hybrid fixation to the all pedicle screw construct, which could produce superior deformity correction. Patient-oriented outcome questionnaires have become an important measure of the success of surgical correction. This study was conducted to assess the outcome of all pedicle screw constructs in treating AIS using the Scoliosis Research Society (SRS)-24 outcome questionnaire.
Patients and methods
Seventy-nine AIS patients were included with a minimum 2-year follow-up. Clinical and radiographic measurements were evaluated at preoperative, postoperative, and final follow-up periods. Complications and results of the SRS-24 questionnaire were analyzed. Sex, Lenke classification, levels of the lowest instrumented vertebra, curve magnitude, and percentage of curve correction were correlated with the SRS-24 questionnaire results.
Results
There were 59 females and 20 males. The mean age of the patients was 14.2 ± 2.5 years. According to Lenke classification, the majority of the curves were type 1 (57 patients), followed by type 5 (11 patients), type 2 (six patients), type 3 (three patients), type 6 (two patients), and no type 4. The mean preoperative major curve Cobb angle was 59.3 ± 9.045° and the mean postoperative Cobb angle was 5.82 ± 5.932°. The average score for SRS-24 was 4.17. The mean preoperative pain score was 3.29, which improved to 4.30 after at least 2 years of follow-up (P˂0.005). Statistically significant improvement was seen in the general self-image, function from back condition, and level of activity. After surgery, the mean score for self-image was 4.19, and for function was 3.55. The postoperative function was the lowest, while the postoperative satisfaction score was the best of all domains, with a mean score of 4.55. About 90% of patients were satisfied with the results of their surgical correction. Magnitude of curve and amount of correction did not significantly alter the SRS scores.
Conclusion
All pedicle screw construct is an efficient and safe method in AIS correction. The surgical treatment in our AIS patients has resulted in a perceived benefit in all domains of SRS-24 questionnaire.