The Efficacy of Single-Stage Correction by Posterior Approach for Neglected Congenital Scoliosis: Comparative Analysis According to the Age of Surgical Intervention

Abstract

Background: A single-stage correction for congenital scoliosis through a posterior-only approach is a commonly used surgical technique. However, there are few studies on the surgical treatment effect of posterior single-stage correction in patients with neglected congenital scoliosis. Methods: Patients who underwent a single-stage posterior correction for congenital scoliosis with a minimum follow-up of 2 years were divided into three groups based on age: Group A (7–11 years), B (12–18 years) and C (>18 years). A comparison of surgical, radiological, and clinical outcomes was performed for three groups. Results: The Cobb angle changed form 75 ± 18° to 37 ± 18° with a correction rate of 53%. Group A showed a significantly higher correction rate than Group B and C (all p < 0.001). The amount of blood loss in Groups B and C was significantly larger than that of Group A (p = 0.015). Pulmonary complications were significantly higher in Group C (p = 0.007). Conclusions: A single-stage correction with pedicle screws through a posterior-only approach achieved a significant correction with improved outcomes, even in neglected cases. However, the early correction for younger patients was still more beneficial in terms of bleeding loss, complications, and flexible curve correction.

The Efficacy of a Posterior Approach to Surgical Correction for Neglected Idiopathic Scoliosis: A Comparative Analysis According to Health-Related Quality of Life, Pulmonary Function, Back Pain and Sexual Function

“…The literature describes a strong correlation between the curve correction and improvement in PF (Table 5). Improving respiratory function before surgery for elective scoliosis correction may reduce the risk of postoperative complications [14,29]. In our study, we arrived at similar conclusions.…”

“…A considerable percentage (28%) of our patients in the MG group preoperatively rated BP as moderate to severe, which is similar to other studies by Ramirez et al, who noted that 23% of patients with AIS were noted with BP at the time of diagnosis [47], and Sieberg et al, who showed that, of 190 patients with AIS, 35% reported moderate to severe pain preoperatively [48]. Some studies have described the prevalence of BP in AIS patients before surgical treatment as being from 42% to 80% [23,[48][49][50][51][52], but the prevalence of BP in patients with AIS and its relation to spinal deformity remains unclear [14,15,17,52]. In our study, there was no noted statistical difference in the back pain between patients managed with HGT, TID, and IT (p < 0.001).…”

“…Experienced surgeons can also use alternative techniques, such as temporary internal distraction rods (TID), intraoperative traction (IT), osteotomies, and apical spine resection, in combination with anterior and posterior approaches to achieve safe and optimal results [6,7,[9][10][11][12][13]. Unfortunately, there are limited data in the literature describing the quality and improvement in the life of patients who undergo surgery for massive and neglected spinal curvatures [14][15][16][17]. There are many studies evaluating the results of surgical treatment, quality of life, pain, sexual function, degree of disability after surgery of the lumbar spine, or treatment of moderate scoliosis.…”

A 16-week school-based intervention improves physical fitness in Slovenian children: a randomized controlled trial

“…During the eighth to ninth year of life, flexibility increases significantly due to progressive growth and adaptation of the musculoskeletal system ( Zhang et al, 2023 ). This increased flexibility allows 8–to 9-year-olds to perform a wider range of movements while reducing the risk of overuse or injury ( Yang et al, 2022 ; Behm et al, 2023 ; Zvetkova et al, 2023 ). Activities that promote flexibility, such as stretching and yoga, can help maintain healthy joints and muscles while promoting awareness of the importance of regular physical activity (PA) ( Chan et al, 2023 ; Y; Cho et al, 2023 ).…”