The Importance of Spinal Mobility Sparing and Health-Related Quality of Life in Adolescent Idiopathic Scoliosis

• Published in: Journal of Spine Research Vol. 13; no. 11; pp. 1186 - 1194
• Main Authors: Sakuma, Tsuyoshi, Iijima, Yasushi, Katogi, Takehide, Okumura, Taro, Kotani, Toshiaki, Minami, Shohei
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society for Spine Surgery and Related Research 20.11.2022; 一般社団法人 日本脊椎脊髄病学会
• Subjects: adolescent idiopathic scoliosis; Health-Related Quality Of Life; trunk flexibility; 体幹柔軟性; 健康関連QOL; 思春期特発性側弯症
• ISSN: 1884-7137; 2435-1563
• DOI: 10.34371/jspineres.2022-1115

Introduction: This study investigated the impact of spinal fusion surgery on global spinal mobility and health-related quality of life in adolescent idiopathic scoliosis (AIS) patients two years postoperatively.Methods: The subjects were 35 patients with AIS who had undergone posterior corrective fixation. Trunk mobility tests (forward flexion, right and left lateral flexion, and extension) and SRS-22 were performed. Two groups divided by the Lowest Instrumented Vertebra (LIV) were compared: 10 cases of thoracic spine fusion (T group: fusion with LIV L1 or higher) and 25 cases of thoracic and lumbar spine fusion (T+L group: fusion with LIV L2 or lower). In the forward flexion, LIV was divided into two groups, L2 and above and L3 and below, for detailed examination. In addition, forward flexion was examined in two groups: LIV above L2 and below L3. The comparison includes spinal mobility and SRS-22 between the two groups.Results: At 2 years postoperatively, the patients had improved to preoperative levels except for anterior flexion; there were significant differences in left lateral flexion and anterior flexion between the T and T+L groups at 2 years postoperatively. There were significant differences in left lateral flexion and forward flexion at 2 years postoperatively in the T and T+L groups. At 2 years postoperatively, there was a significant difference between the T and T+L groups in the Function of the SRS-22 score.Conclusions: Two years postoperatively, there was still a significant decrease in mobility compared to the group with LIV of L1 or higher with LIV of L2 or lower. Forward flexion was significantly better than preoperatively in the group with LIV above L2, but did not correlate with LIV. Function of SRS-22 also showed a significant decrease in the group with LIV less than L2.