Extreme long-term outcome of operatively versus conservatively treated patients with adolescent idiopathic scoliosis.,European Spine Journal

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Extreme long-term outcome of operatively versus conservatively treated patients with adolescent idiopathic scoliosis.
European Spine Journal ( IF 2.8 ) Pub Date : 2020-06-25 , DOI: 10.1007/s00586-020-06509-1
Mazda Farshad ₁ , Lucas Kutschke ₁ , Christoph J Laux ₁ , Method Kabelitz ₁ , Regula Schüpbach ₁ , Thomas Böni ₁ , Thorsten Jentzsch ₁

Affiliation

Purpose

We report on outcomes of surgically versus (vs) non-surgically treated patients with moderate adolescent idiopathic scoliosis (AIS) after minimum of 29 years.

Methods

AIS patients with a follow-up of ≥ 41 years in the surgical group and ≥ 29 years in the non-surgical group were included. Patients were treated surgically for primary curves ≥ 45° vs non-surgically for curves < 45° or refusal of surgery. Groups were matched for age, gender, comorbidities and primary curve severity. Oswestry Disability Index (ODI) was used to measure clinical outcomes and standard radiography to quantify curve severity at final follow-up.

Results

In total, 16 patients (8 within each group, 75% females) with a median age of 14 (interquartile range (IQR) 2) years could be included and were followed up after 46 (IQR 12) years. All matched variables were similar for both groups, including the primary curve Cobb angles of 48° (IQR 17°) (surgical) vs 40° (IQR 19°) (non-surgical); p = 0.17). At final follow-up after a median of 47 (IQR 5) years for the surgical and 39 (IQR 19) years for the non-surgical group (p = 0.43), the ODI was similar for both groups (15 (IQR 13) points (surgical) vs 7 (IQR 15) points (non-surgical); p = 0.17) with, however, a primary curve magnitude lower in the surgical compared to the non-surgical group (38° (IQR 3°) vs 61° (IQR 33°); p = 0.01), respectively.

Conclusion

After around 47 and 39 years, respectively, surgical and non-surgical treatment of moderate AIS showed similar subjective outcomes, but with a relevant smaller curve magnitude with surgical treatment.

Level of evidence

III

中文翻译：

手术与保守治疗青少年特发性脊柱侧弯患者的极长期结果。

目的

我们报告了中度青少年特发性脊柱侧凸 (AIS) 患者在至少 29 年后接受手术与（vs）非手术治疗的结果。

方法

手术组随访≥41年的AIS患者和非手术组随访≥29年的AIS患者被纳入。患者的主要曲线≥ 45° 接受手术治疗，而曲线 < 45° 或拒绝手术的患者接受非手术治疗。各组的年龄、性别、合并症和初级曲线严重程度相匹配。Oswestry 残疾指数 (ODI) 用于测量临床结果和标准放射照相术以量化最终随访时的曲线严重程度。

结果

总共有 16 名患者（每组 8 名，75% 为女性），中位年龄为 14（四分位距（IQR）2）岁，并在 46（IQR 12）年后进行随访。两组的所有匹配变量都相似，包括 48°（IQR 17°）（手术）与 40°（IQR 19°）（非手术）的主要曲线 Cobb 角；p = 0.17）。手术组中位数为 47 (IQR 5) 年，非手术组为 39 (IQR 19) 年 ( p = 0.43)，在最终随访时，两组的 ODI 相似 (15 (IQR 13)点（手术）与 7 (IQR 15) 点（非手术）；p = 0.17）但是，与非手术组相比，手术组的主要曲线幅度较低（38°（IQR 3°）对 61） ° (IQR 33°); p = 0.01)，分别。