Subjective perception of spinal deformity after selective versus non-selective fusion of Lenke 1C curves

Abstract

Purpose To assess the self-image perception and the Quality-of-Life (QoL) in female adolescents, with Lenke 1C scoliosis curves, treated with selective versus non-selective posterior spinal instrumentation and fusion (PSF). Methods Patients undergoing PSF for idiopathic adolescent scoliosis (AIS) were recruited and divided into two groups: patients managed with selective thoracic fusion (STF) were included in Group A, whereas patients treated with non-selective fusion (N-STF) in Group B. Each patient completed the Italian version of the Scoliosis Research Society-22R questionnaire (SRS-22R), the Quality-of-Life Profile for Spinal Deformities questionnaire (QLPSD) and the Spinal Appearance Questionnaire (SAQ), before surgery and at 24-month follow-up. Results One hundred and fifty seven female patients (mean age 16.38) were included in this study. 80 patients underwent STF, while 77 patients received N-STF. At 24-month follow-up, patients managed with N-STF showed better SRS-22R self-image mean score (p = .012), SRS-22R satisfaction mean score (p = .033), QLPSD body image mean score (p = .005), but worse SRS-22 function mean score (p = .006) and QLPSD back flexibility mean score (p = .007), compared with patients who underwent STF. In terms of self-image perception, patients undergoing STF showed significantly worse SAQ total mean score (p = .002), SAQ appearance mean score (p = .001) and SAQ expectation (p = .001). We found a significant correlation between SAQ appearance mean score and SRS-22R self-image (R = − 0.721), SRS-22 mental health (R = − 0.8), QLPSD psychosocial functioning (R = 0.7) and QLPSD back flexibility (R = 0.8). Conclusion Although the STF of Lenke 1C curves provides better functional outcomes, in the present study, female patients receiving STF revealed a worse perceived body image, compared with patients treated with N-STF, at 24-month follow-up. Particular attention should be addressed to the preoperative patient’s mental health and body image perception, when choosing between STF and N-STF.

The Importance of Lumbar Curve Flexibility and Apical Vertebral Rotation for the Prediction of Spontaneous Lumbar Curve Correction in Selective Thoracic Fusion for Lenke Type 1 and 2 C Curves: Retrospective Cohort Study with a Mean Follow-Up of More than 10 years

“…This finding is tought to be due to small number of patients in groups. 36 In conclusion when the flexibility in the preoperative bending x-ray is more than 70% (P < .01) and when AVR is equal or less than 2 grades in Lenke 1C and Lenke 2 C curves, STF provides satisfactory clinical and radiological SLCC at a mean follow up of 12.2 (minimum 8 and maximum 23) years. In addition, our study showed that a flexibility rate of the lumbar curve greater than 70% and a preoperative AVR grade equal to or less than 2 grades are more important criteria than the preoperative lumbar curve magnitude and preoperative AVT distance in the decision making of STF and for the prevention of coronal plane decompensation in Lenke 1-2 C curves.…”

Impact of Different Operative Techniques for Patients With Adolescent Idiopathic Scoliosis on Frontal Curve Correction and Sagittal Balance

“…The demographic data of our group of patients with an average age of 14.71 years and a female predominance, as well as the average preoperative Cobb angles and curve types, are comparable to data reported in other recent investigations. [8][9][10][11][12][13][14][15][16][17][18][19] This seems to indicate that our study population may be representative.…”

“…9 However, other investigations showed that SF compared with NSF led to a minor correction of the nonstructural curves. 10,11 According to the subjective perception of the patients, Bizzoca et al showed that although the SF provides better functional outcomes, female patients receiving SF reported a worse perceived body image compared with patients treated with NSF. 12 Surgical correction from the posterior can be performed by an all screws technique (AS), hybrid technique with screws and hooks (HTH), or hybrid technique with screws, hooks, and tapes (HTHT).…”

Gender-Related Factors Influence the Subjective Perception of Deformity in Patients Undergoing Surgery for Idiopathic Scoliosis

“…Scoliosis is a three-dimensional spine deformity defined by a Cobb angle greater than 10 • with combined vertebral rotation [1].…”

“…It typically occurs between the ages of 10 and 18, with no identifiable cause or underlying pathology [2,3]. This condition affects approximately 2-4% of adolescents, with a higher prevalence in females than males [1][2][3].…”