General Session: Pediatric Spine
Presented by: I. Lieberman - View Audio/Video Presentation (Members Only)
W. Lavelle(1), X. Hu(2), S. Kurra(1), I. Lieberman(2)
(1) SUNY Upstate Medical University, Syracuse, NY, United States
(2) Texas Back Institute, Texas Health Presbyterian Hospital Plano, Scoliosis and Spine Tumor Center, Plano, TX, United States
Introduction: The surgical outcome of adolescent idiopathic scoliosis (AIS) patients has been well studied. However, few studies have compared the surgical outcome of idiopathic scoliosis patients who underwent surgery as young adults (> 18 years) with those who had surgery as adolescents (≤ 18 years). The purpose of this study is to review a series of young adult and adolescent idiopathic scoliosis patients who have undergone correction surgery and to compare their clinical outcome.
Methods: Data were retrospectively reviewed from consecutive young adult (19 - 30 years old) and adolescent (11 - 18 years old) idiopathic scoliosis patients who have undergone correction surgery between 2010 and 2014 by two spine surgeons. Patients who had previous correction surgery were excluded from this study. Peri-operative (up to 90 days post-op) and post-operative complications (including additional surgery) were reviewed. Radiographic measurements were obtained pre-operatively and at the latest follow-up.
Results: There were 27 young adult and 29 adolescent patients. The patients' gender, BMI, and follow up interval were not statistically different. Young adult patients had more back pain pre-operatively (5.7 vs 4.5, p=0.02). The average pre-operative main coronal curve was 53° in young adult and 57° in adolescent patients (p>0.05). There were more levels fused in young adult patients (10.6 vs 8.9, p=0.02). Intra-operative blood loss was significantly higher in young adult patients (872 ml vs 564 ml, p= 0.02). The length of surgery was not different between these two groups (344 min vs 377 min, p>0.05). Two young adult patients (7.4%) and 0 adolescent patients (0%) had peri-operative complications (p=0.14). Young adult patients had relatively longer hospital stay (5.8 vs 4.9 days, p=0.11). At mean 21 months (range 6 - 46 months) follow up, the patients in both groups had significant correction of their main coronal curve (21° vs 53° in young adult patients, p< 0.001; 19° vs 57° in adolescent patients, p< 0.001). Young adult patients had lower percentage correction of their curves (61% vs 68%, p=0.03). Three young adult (11.1%) and 0 adolescent patients (0%) had additional surgery (p=0.07).
Conclusion: Our study shows that comparing with adolescent patients, young adult patients who underwent idiopathic scoliosis surgery tend to have more levels fused, relatively higher peri-operative complication rate and relatively longer hospital stay. They also have lower percentage correction of their main coronal curve and relatively higher rate of additional surgery. Future studies are needed to assess the long term surgical outcome of young adult idiopathic scoliosis patients.