Minimum 20-Year Health-Related Quality of Life and Surgical Rates After the Treatment of Adolescent Idiopathic Scoliosis

A. Noelle Larson, Fady Baky, Ali Ashraf, Yaser M. Baghdadi, Vickie Treder, David W. Polly, Michael J. Yaszemski

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Study Design: Longitudinal cohort. Objectives: To determine the patient-reported functional outcomes and need for related surgical procedures in a US cohort of adolescent idiopathic scoliosis (AIS) patients with minimum 20-year follow-up. Summary of Background Data: There is limited information regarding the long-term outcomes of scoliosis treatment in the US population. Methods: A novel population of patients who underwent pediatric treatment for AIS with minimum 20-year follow-up was identified. Search of a single-center diagnostic registry generated 337 patients who fulfilled the inclusion criteria (AIS, curve magnitude >35°, and childhood treatment with bracing, surgery, or observation from 1975 to 1992). Any additional spine surgery as well as EQ5D, ODI, SRS 22, SAQ were determined. A total of 180 patients were included (mean of 30-year follow-up, range 20-37). Childhood treatment entailed bracing (41 patients), surgery (103 patients), and observation (36 patients). Results: During the study period, only 1 of the 41 bracing patients underwent additional scoliosis-related spine surgery, whereas 5 of the 36 patients in the observation cohort underwent scoliosis surgery as adults. Seven of 103 childhood surgical patients required additional revision surgery as adults. Fifteen patients (4 braced, 7 fusion, and 4 observed) underwent chest wall surgery as adults. SRS scores were around 10% worse compared to population-based controls, with the exception of SRS mental health scores, which were similar to controls. Overall, 5.6% of patients were on disability, with no difference between operative and nonoperative groups. Conclusion: We found a low rate of adult scoliosis surgery in the braced population, and a low rate of revision surgery at the 30-year follow-up in patients undergoing spine fusion for AIS between 1975 and 1992. No detected differences in patient-reported outcomes were found between the braced, surgical, and observed populations at a mean of 30 years' follow-up. Level of Evidence: Level III, therapeutic.

Original languageEnglish (US)
Pages (from-to)417-427
Number of pages11
JournalSpine deformity
Issue number3
StatePublished - May 2019


  • Adolescent idiopathic scoliosis
  • Bracing
  • Fusion
  • Health-related quality of life
  • Long-term
  • Observation

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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