A retrospective case-series of adolescent idiopathic scoliosis patients with 5 to 15 years follow-up after segmental pedicle screw instrumentation

Background The long-term outcome of surgery for adolescent idiopathic scoliosis (AIS) using segmental pedicle screw constructs is sparsely described in the scientific literature.Methods Retrospective case series of 120 consecutive patients operated for AIS using segmental pedicle screw constructs. Age between 11 and 21 years of age at the time of surgery (25 males) and followed median 9 years after surgery. Outcome measures consisted of radiological variables, the SRS-22 and the EQ-5D-5L questionnaires, questions concerning work status and the most advanced educational level at last follow-up. An electronic questionnaire was answered in 120 of 148 cases (81%) and 112 (76%) showed up for the long-term radiology control. Preoperative PROMS were available from the national research register for spine surgery. Attributable to the incompleteness of the register only a third of the PROM data were paired.Results The frequency of complications was 12.5%. Mean curve correction was 78% immediately preoperative with a 4° increase at last follow-up. SRS-22 total/self-image and the EQ-5D utility scores were significantly improved at last follow-up. At last follow-up 84% were satisfied or very satisfied with the results of the surgical intervention. Socioeconomic factors, Lenke type 2, number of levels instrumented and curve correction were important predictors for satisfaction in a logistic regression model (AUC 85%).Conclusions Only 16% were not satisfied with the results of AIS surgery after 5 to 15 years. Total PROM scores and self-image scores were significantly improved at last follow-up. Socioeconomic factors are important when analyzing the results of AIS surgery.