Evaluation of the results of Scoliosis Surgeries in Iraq: A Five-Year Follow-Up Study
DOI:
https://doi.org/10.22317/jcms.v11i4.1986Keywords:
Scoliosis/surgery, Spinal Fusion/methods, Adolescent, Spinal Curvatures, Musculoskeletal AbnormalitiesAbstract
Objective: This study set out to look at how safe and effective posterior spinal fusion (PSF) surgery is in scoliosis patients, and to explore both the complications and the outcomes after treatment.
Methods: We carried out a prospective study of 90 patients with scoliosis who underwent PSF surgery at Ibn Sina Training Hospital in Baghdad between 2019 and 2024. Each patient was followed both clinically and radiographically to check for complications during and after surgery. Radiographic evaluation focused on device failure, union or pseudoarthrosis, and the need for revision. Clinical outcomes were assessed using Cobb angle correction, pain reduction (Visual Analogue Scale, VAS), and patient satisfaction.
Results: The average age at surgery was 10 ± 5.1 years, and patients were followed for about 5 ± 3.2 years. Most surgeries went smoothly, though some complications were observed, including infection, broken screws or rods requiring revision, and cases of hemo- or pneumothorax, which required chest tube placement in 14 patients. Three of these complications resolved within the first postoperative week. Overall, pain levels were well controlled, with a mean postoperative VAS score of 2.1 ± 0.7, and patients reported good satisfaction with the outcome.
Conclusion: This study suggests that PSF surgery for idiopathic scoliosis is both safe and effective, particularly when performed close to skeletal maturity. With at least five years of follow-up, our findings indicate that early surgical intervention can improve outcomes, reduce pain, and minimize the risk of complications. Delaying surgery well beyond skeletal maturity, however, appears to increase the likelihood of problems after treatment.
References
Han J, Xu Q, Yang Y, Yao Z, Zhang C, Evaluation of quality of life and risk
factors affecting quality of life in adolescent idiopathic scoliosis. In: Intractable
and rare diseases research (Vol. 4, Issue 1, pp. 12–16). International Advancement Center for Medicine and Health Research (2015). https://doi. org/ 10. 5582/ irdr. 2014. 01032.
Sanders JO, Carreon LY, Sucato DJ, Sturm PF, Diab M. Preoperative and perioperative factors effect on adolescent idiopathic scoliosis surgical outcomes. Spine. 2010;35(20):1867–71. https:// doi. org/ 10. 1097/ BRS. 0b013 e3181 efa6f5.
Rodrigues LMR, Gotfryd AO, Machado AN, Defino M, Asano LYJ. Adolescent
idiopathic scoliosis: surgical treatment and quality of life. Acta Ortopedica Brasileira. 2017;25(3):85–9. https:// doi. org/ 10. 1590/ 1413- 78522 01725 03157 788.
Pellegrino LN, Avanzi O. Prospective evaluation of quality of life in adolescent
idiopathic scoliosis before and after surgery. J Spinal Disord Tech. 2014;27(8):409–14. https:// doi. org/ 10. 1097/ BSD. 0b013 e3182 797a5e.
Kotwicki T, Chowanska J, Kinel E, Czaprowski D, Tomaszewski M, Janusz P.
Optimal management of idiopathic scoliosis in adolescence. Adolesc HealthMed Ther. 2013;4:59.
Viviani G, Raducan V, Bednar D, Grandwilewski W. Anterior and posterior
spinal fusion: comparison of one-stage and two-stage procedures. Can J Surg. 1993;36:468–73.
Gornitzky AL, Flynn JM, Muhly WT, Sankar WN (2016) A rapid recovery pathway for adolescent idiopathic scoliosis that improves pain control and reduces time to inpatient recovery after posterior spinal fusion. Spine Deform 4:288–295
Chan CYW, Loo SF, Ong JY, Lisitha KA, Hasan MS, Lee CK et al (2017) Feasibility and outcome of an accelerated recovery protocol in Asian adolescent idiopathic scoliosis patients. Spine Phila Pa (1976) 42:E1415–E1422
Kim E, Lee B, Cucchiaro G (2017) Perioperative surgical home: evaluation of a new protocol focused on a multidisciplinary approach to manage children undergoing posterior spinal fusion operation. Anesth Analg 125(3):812–819. https:// doi. org/ 10. 1213/ANE. 00000 00000 002030
Weinstein et al. (2013). Adolescent idiopathic scoliosis: a review of the literature. Journal of Pediatric Orthopedics, 33(5), 531-536
.
Lonstein et al. (2013). Surgical treatment of adolescent idiopathic scoliosis: a review of the literature. Journal of Pediatric Orthopedics, 33(5), 537-544.
Fletcher et al. (2014). Return to activity after surgical treatment of adolescent idiopathic scoliosis. Journal of Pediatric Orthopedics, 34(5), 531-536.
Buttermann GR, Mullin WJ. Pain and disability correlated with disc
degeneration via magnetic resonance imaging in scoliosis patients. Euro
Spine J. 2008;17:240–9.
Sponseller PD, Cohen MS, Nachemson AL, Hall JE, Wohl ME: Results of surgical treatment of adults with idiopathic scoliosis. J Bone Joint Surg Am. 1987, 69:667-675. 10.2106/00004623-198769050-00005
Hisam MA, Siti NS, Jou NP, Ghaneshinee S, Shaharuddin AR, Azmi B, Mohd
K. Does the quality of life in operated patients with adolescent idiopathic
scoliosis correspond with the radiographic parameters? Malaysian Orthopaedic
J. 2015;9(2):37–40. https:// doi. org/ 10. 5704/ MOJ. 1507. 010.
Rushton PR, Grevitt MP. What is the effect of surgery on the quality of
life of the adolescent with adolescent idiopathic scoliosis? A review and
statistical analysis of the literature. Spine. 2013;38(9):786–94.
Djurasovic M, Glassman SD, Sucato DJ, Lenke LG, Crawford CH. Improvement
in Scoliosis Research Society-22R Pain Scores After Surgery for
Adolescent Idiopathic Scoliosis. Spine. 2018;43(2):127–32. https:// doi. org/
1097/ brs. 00000 00000 001978.
Herdea A, Stancu TA, Ulici A, Lungu CN, Dragomirescu M-C, Charkaoui A.
Quality of life evaluation using SRS-30 score for operated children and adolescent idiopathic scoliosis. Medicina. 2022;58:674. https:// doi. org/ 10.
/ medic ina58 050674.
Di Silvestre M, Bakaloudis G, Lolli F, Vommaro F, Martikos K, Parisini P. Posterior fusion only for thoracic adolescent idiopathic scoliosis of more than 80 degrees: pedicle screws versus hybrid instrumentation. Eur Spine J. 2008;17(10):1336-49. doi: 10.1007/s00586-008-0731-9.
Zhang J, He D, Gao J, Yu X, Sun H, Chen Z, et al. Changes in life satisfaction and self-esteem in patients with adolescent idiopathic scoliosis with and without surgical intervention. Spine (Phila Pa 1976). 2011;36(9):741-5. doi:10.1097/BRS.0b013e3181e0f034.
Han J, Xu Q, Yang Y, Yao Z, Zhang C. Evaluation of quality of life and risk factors affecting quality of life in adolescent idiopathic scoliosis. Intractable Rare Dis Res. 2015;4(1):12-6. doi: 10.5582/irdr.2014.01032.
Ghandhari, H., Ameri, E., Nikouei, F. et al. Long-term outcome of posterior spinal fusion for the correction of adolescent idiopathic scoliosis. Scoliosis 13, 14 (2018). https://doi.org/10.1186/s13013-018-0157-z
Coe et al. (2018). Complications of surgical treatment of adolescent idiopathic scoliosis: a systematic review. Spine, 43(10), 739-746.
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