Adolescent idiopathic scoliosis: outcome after surgical treatment

Since Adolescent Idiopathic Scoliosis (AIS) is most common seen spinal deformity, various classification systems have been described, which helps clinicians to determine the correct intervention method, whether surgical or non-surgical. Diagnosis and treatment aproaches vary among patients. Recent innovations in surgical treatment of AIS, especially the pedicle screws and its effective placement at every level, lead to improve surgical outcomes, (i.e., increased rates of curve correction, decrease in correction loss, better balance in sagittal and frontal planes). Due to increased experiences of surgeons in posterior instrumentation, surgical complications significantly decreased as well. Although surgical outcomes are mostly favorable, clinical outcomes are almost disregarded. Therefore, the Scoliosis Research Society (SRS) developed a SRS-22 questionnaire with 5 subclassifications, in which high results correspond to good clinical outcomes. 29 (female n: 23; male n: 6) out of 34 patients with AIS, who surgically treated at our clinic and met our inclusion criterias, were inluded in the present study. Mean age of female and male patients was 15,47 +/- 2,59 and 17 +/- 2,09, respectively. And the mean follow-up time was 29 months. Pre-and post-operatively curve degrees were measured and correction rates were noted. SRS-22 questionnaire was applied to every patient pre-and post-operatively. All results were compared statistically between male and female groups. We did not found statistically significant correlation between surgical outcomes and clinical outcomes derived from SRS-22 questionnaire, which means surgical correction rates does not evenly affect clinical outcomes. In comparison between sex groups, only changes in appearance differed significantly. Total and all subgroup scores of SRS-22 questionnaire have also significantly increased post-operatively. Balance in frontal and sagittal plane improved postoperatively as well. As a conclusion, with low rates of complication, posterior instrumentation and fusion in AIS can succesfully help to correct scoliotic curves and aid in patient satisfaction.