Adolescent vs. Young Adult Idiopathic Scoliosis patients: how different are their two year postoperative radiographic and clinical outcomes?

Purpose To compare the long-term outcomes among AIS (10-18 years) and young AdIS (YAdIS) (19-40 years) patients with minimum 2 year follow up. Methods A retrospective review of AIS and YAdIS patients who underwent primary corrective surgery at a single center was conducted. Demographic, radiographic, operative data, patient reported outcome measures (PROMs), including the ODI and SRS-22r, and long-term complications were collected. A 1:1 propensity score matched (PSM) analysis was implemented to limit selection bias by controlling for gender, curve type, total instrumented levels (TIL), and main coronal cobb angle. Results 95 patients (60 AIS, 35 YAdIS) were identified. Following PSM, 27 matched pairs were identified. AIS patients had greater LL (-55.6 +/- 14.0 vs. -61.8 +/- 11.7, p = 0.0486) at preop, less OR time (4.7 +/- 1.2 h vs. 5.2 +/- 1.5 h, p = 0.0468), intraoperative transfusion rates (70.4% vs. 96.3%, p = 0.0082), and postop Hb (9.0 +/- 1.9 vs. 10.1 +/- 1.4, p = 0.0280) and Hct (26.4 +/- 5.4 vs. 29.7 +/- 3.7, p = 0.0453). YAdIS patients had greater T2-T12 TK (42.7 +/- 13.6 vs. 36.3 +/- 11.0, p = 0.0412), T2-T5 TK (19.4 +/- 9.4 vs. 13.3 +/- 8.7, p = 0.0187), and TPA (12.4 +/- 7.9 vs. 7.4 +/- 8.9, p = 0.0200). There were no significant differences in baseline and 2 year follow up PROMs and in the rates of 2 year complications, including proximal/distal junctional kyphosis (PJK/DJK), pseudarthrosis, rod fracture, curve progression, and revision (p > 0.05). Conclusion Despite differences in operative characteristics, idiopathic scoliosis (IS) patients who underwent corrective surgery at a younger age had comparable PROMs and 2 year outcomes to older patients. Corrective fusion surgery is safe and effective in both adolescents and young adults and may avoid the higher complication rates seen in older adults.