Mid-long-term outcome and degeneration of the remaining unfused lumbar intervertebral disc in adolescent idiopathic scoliosis patients who had posterior spinal fusion surgery
Document Type
Article
Publication Date
7-1-2021
Abstract
Purpose To investigate mid-long-term effects of the lowest instrumented vertebra (LIV) selection on adolescent idiopathic scoliosis (AIS) patients who had posterior spinal fusion (PSF) surgery. Methods Forty-eight patients were recruited. Inclusion criteria were AIS patients who have had PSF surgery more than 10 years ago. Patients were divided into G1: LIV L3 or higher and G2: LIV L4 or lower. MRI evaluation was classified using Pfirrmann grades. Pfirrmann scores were average of Pfirrmann grades for all unfused discs below LIV. SRS-22r, SF-36, Oswestry Disability Index (ODI) and Modified Cincinnati Sports Activity Scale (MCSAS) were used. Results There were 19 patients in G1 and 29 patients in G2. Demographic parameters showed no significant differences. We found no significant differences in Pfirrmann grades or scores between G1 and G2. There was significant correlation between age and mean Pfirrmann scores (r = 0.546, p < 0.001), Pfirrmann grade for adjacent disc + 1 below LIV (r = 0.475, p = 0.001) and adjacent disc below LIV (r = 0.365, p = 0.011). G2 had significantly lower scores for SRS-22r pain (G1: 4.3 +/- 0.5, G2: 4.0 +/- 0.6, p = 0.044) and the SF-36 bodily pain (G1: 88.7 +/- 12.3, G2: 77.8 +/- 18.7, p = 0.018) domains. There were no significant differences in ODI and MCSAS between the two groups. Conclusions Patients with fusion to L4 or lower had more significant back pain. However, both groups had similar physical function, self-image, satisfaction with treatment, mental health, and functional sports activity. We did not find any significant association between lumbar discs degeneration and the selection of LIV.
Keywords
Adolescent idiopathic scoliosis, Long-term outcome, Disc degeneration, Magnetic resonance imaging, Lowest instrumented vertebra
Divisions
ortho
Publication Title
European Spine Journal
Volume
30
Issue
7
Publisher
Springer
Publisher Location
ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES