Correlation of radiographic parameters and patient satisfaction in adolescent idiopathic scoliosis treated with posterior screw-dual-rod instrumentation

PurposeIn surgical treatment of adolescent idiopathic scoliosis (AIS), only a few studies measure both, radiological parameters and PROMs and correlate them.MethodsProspectively collected AIS-data of one scoliosis-center within a multicenter German-Spine-Society-Study. All patients underwent instrumented posterior spinal correction and fusion with pedicle-screw-dual-rod-systems from 05/2019 to 01/2021. The data were retrospectively analyzed. Inclusion criteria: age 11-17 years, follow-up (FU) at least 12 months. Clinical data, radiographic parameters, and PROMs (SRS-30-questionnaire) were collected. 100% of patients had X-ray images, 88.2% completed SRS-30. Parameters were given as mean & PLUSMN; SD. Differences and subdivision by lower instrumented vertebra (LIV) were analyzed by students t-test (significancy a = 0.05), associations by Pearson's correlation.ResultTotal of 51 patients: 15 & PLUSMN; 1.4 years, BMI 20.7 & PLUSMN; 3.7 kg/m(2), FU 16.6 & PLUSMN; 6.1 months, fusion length 9.2 & PLUSMN; 2.3 segments, implant density 93 & PLUSMN; 9%, surgical time 215 & PLUSMN; 71 min, mean blood loss 504 & PLUSMN; 360 ml. Mean preoperative Cobb angle of main curve 64 & PLUSMN; 14 & DEG;, of secondary main curve 46 & PLUSMN; 12 & DEG;, corrected by 68 & PLUSMN; 11%, 56 & PLUSMN; 17%, respectively. Mean thoracic rib and lumbar hump significantly decreased by - 8.5 & PLUSMN; 7.0 & DEG; and - 7.7 & PLUSMN; 8.9 & DEG; (p < 0.5). High thoracic rib hump almost unchanged, - 0.4 & PLUSMN; 2.8 & DEG; (p = 0.3). Thoracic kyphosis (- 0.9 & PLUSMN; 12.8 & DEG;, p = 0.6), lumbar lordosis (1.5 & PLUSMN; 10.1 & DEG;, p = 0.3), clavicle angle (- 0.5 & PLUSMN; 2.7 & DEG;) and spinopelvic parameters (p > 0.5) did not significantly change, only LIV-tilt from 24.5 & PLUSMN; 6.7 & DEG; to 6.5 & PLUSMN; 4.3 & DEG; (p < 0.05). PROMs significantly improved (p < 0.05), no significant improvement for function/activity (p = 0.4). Preoperative mean total-score was 3.6 & PLUSMN; 0.5, 4.2 & PLUSMN; 0.3 at FU(p < 0.05). Self-image improved in 67%. Moderately strong correlation for PROMs: the better LIV-tilt (r = - 0.5) correction and the shorter surgery time (r = - 0.4), the better SRS-30 total-score. No correlation for curve correction and patient's satisfaction.ConclusionIn summary, results of this study demonstrate good surgical correction and significant improvement of most PROMs.