Posterior-only correction surgery for idiopathic scoliosis Lenke type 5c: differences of strategies and outcomes between adult patients and adolescent patients

Abstract

Purpose To compare radiographic parameters, and functional and surgical outcomes between lumbar adolescent idiopathic scoliosis (AIS) and lumbar adult idiopathic scoliosis (AdIS). Methods A retrospective study was performed to identify Lenke 5c type AIS and AdIS patients from our scoliosis database who had undergone posterior surgical treatment for scoliosis. Preoperative and postoperative radiographic and clinical outcomes were compared between the two groups. Results A total of 22 patients were included in AdIS group, and 44 matched patients in AIS group. AdIS group had significantly larger L3 and L4 tilt and translation than AIS group (P < 0.05). AdIS group had larger T10-L2 angle and smaller T5–T12 angle (P < 0.05). AdIS group had higher VAS scores (P < 0.05) and pain domain of SRS-22 scores (P < 0.05) as compared to AIS group. Correlation analysis demonstrated positive relationship between VAS scores and T10-L2 angle (r = 0.492, P < 0.05). AdIS group was fused longer than AIS group (P < 0.05). Cobb angle of TL/L curve was larger and correction ratio was smaller at AdIS group (P < 0.05). AdIS group still had significantly larger L3 and L4 tilt and translation than AIS group (P < 0.05). CT measurements demonstrated larger postoperative vertebral body rotation at apical vertebrae and LIV at AdIS group (P < 0.05). Vertebral correction ratio was smaller at AdIS group (P < 0.05). Conclusion Lenke 5c AdIS patients had greater preoperative and postoperative L3 and L4 tilt and translation, as well as less correction of major curve and vertebral body derotation than AIS patients. However, the incidence of adding-on was similar between the two groups.

Biomechanical study of spinal cord and nerve root in idiopathic scoliosis: based on finite element analysis

“…Therefore, this study primarily focuses on comparative analysis at a 40mm displacement. Pan et al [31], through a retrospective analysis comparing correction outcomes of Lenke 5c type AIS and Adult Idiopathic Scoliosis (AdIS), found that the correction rate for AIS was 79.1% ± 13.2, while for AdIS, it was 65.6% ± 15.7. Yang et al [32], using titanium and cobalt-chromium alloy for adolescent idiopathic scoliosis correction, found that the correction rate for thoracic curvature was 71.2% in the titanium group and 66.8% in the lumbar curvature, whereas in the cobalt-chromium alloy group, the thoracic and lumbar correction rates were 71.2% and 73.3%, respectively.…”

Adolescent idiopathic scoliosis in adulthood

“…This can result in restrictions in daily activities, such as difficulties in walking, exercising, and socializing. Surgery tends to be more painful for adult patients compared to adolescents, but long-term outcomes show a significant reduction in pain regardless ( 54 ).…”

“…On the other hand, patients with severe AIS, particularly with curves greater than 50°, note significant limitations in activities of daily living and physical functioning. Surgical treatment in this population can prevent and alleviate these conditions, with treated adults showing significant improvements in their physical functioning ( 54 ). Such restoration in functional mobility can also improve performance at work, reducing absenteeism and increasing productivity by 18.1% post-surgical intervention ( 56 ).…”