Results of the Surgical Approach of Idiopathic Scoliosis in Adolescents and Postoperative Quality of Life: Systematic Literature Review

Abstract

Adolescent idiopathic scoliosis is considered the most severe and common spinal deformity, affecting children and adolescents still in the neuropsychomotor development phase before they reach skeletal maturity.

This study aimed to evaluate the surgical approach to adolescent idiopathic scoliosis (AIS), considering the results associated with the reduction of pathological curvature, pulmonary function, and repercussions on the quality of life of adolescents undergoing such treatment.

Systematic literature review, with a quantitative and qualitative approach to the data collected, structured according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), carried out in the databases linked to the Medical Literature Analysis and Retrieval System Online (MEDLINE) and Latin American and Caribbean Health Sciences Literature (LILACS). The total sample of the studies was 638 adolescents with AIS, with a mean age of 14.93 years ± 1.24. The mean correction of the main pathological curvature in the studies was 55.06% ± 12.24.

In all of the selected studies using posterior spinal fusion to correct AIS, there was a significant reduction in pathological curvatures (> 49%), and the recurrence of curvature in none of the studies exceeded a pathological gain of more than 5%. As for lung function, the studies showed significant increases in forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) in patients with severe AIS, and no pulmonary function losses were reported after surgery to correct AIS.

Keywords

adolescent - orthopedic surgery - scoliosis

Work carried out at the University of Salvador (UNIFACS), Salvador, BA, Brazil.

Publication History

Received: 29 April 2020

Accepted: 25 August 2023

Article published online:
22 June 2024

• Referências

• 1 Verttú Schmidt A, Mantelatto Andrade R, Ferreira Novo N, Ribeiro AP. Reliability and validity between two instruments for measuring spine sagittal parameters in adolescents with idiopathic scoliosis during various stages of growth. Med Leg Costa Rica 2022; 39 (02) 51-68
• 2 Knott P, Lonner B, Smith M, Frommeyer E, Ren Y. Measuring anterior trunk deformity in scoliosis: development of asymmetry parameters using surface topography (a pilot study). Scoliosis Spinal Disord 2016; 11 (Suppl. 02) 32
• 3 Wu W, Liang J, Du Y. et al. Reliability and reproducibility analysis of the Cobb angle and assessing sagittal plane by computer-assisted and manual measurement tools. BMC Musculoskelet Disord 2014; 15: 33
• 4 Yılmaz H, Zateri C, Kusvuran Ozkan A, Kayalar G, Berk H. Prevalence of adolescent idiopathic scoliosis in Turkey: an epidemiological study. Spine J 2020; 20 (06) 947-955
• 5 Curbelo-Nova PC, Silveri C, Cuneo A. Escoliosis idiopática del adolescente, análisis postoperatorio. Serie de casos. Rev Colomb Ortop Traumatol 2021; 35 (02) 126-132
• 6 Penha PJ, Ramos NLJP, de Carvalho BKG, Andrade RM, Schmitt ACB, João SMA. Prevalence of Adolescent Idiopathic Scoliosis in the State of São Paulo, Brazil. Spine 2018; 43 (24) 1710-1718
• 7 Dunn J, Henrikson NB, Morrison CC, Blasi PR, Nguyen M, Lin JS. Screening for Adolescent Idiopathic Scoliosis: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2018; 319 (02) 173-187
• 8 Benítez López R. Coll Costa J de L, Rodríguez García AR, Quetglas González LR, Machín Quiñonez NM. Programa de ejercicios físicos correctivos para pacientes con escoliosis idiopática. Rev Podium 2022; 17 (02) 583-596
• 9 Berdishevsky H, Lebel VA, Bettany-Saltikov J. et al. Physiotherapy scoliosis-specific exercises - a comprehensive review of seven major schools. Scoliosis Spinal Disord 2016; 11 (01) 20
• 10 Costa RP, Silva AI. Escoliose idiopática do adolescente: Diagnóstico e tratamento conservador. Rev SPMFR 2019; 31 (04) 19-36
• 11 Di Felice F, Zaina F, Donzelli S, Negrini S. The natural history of idiopathic scoliosis during growth. Am J Phys Med Rehabil 2018; 97 (05) 346-356
• 12 Liberati A, Altman DG, Tetzlaff J. et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 2009; 6 (07) e1000100
• 13 Booth A. Searching for qualitative research for inclusion in systematic reviews: a structured methodological review. Syst Rev 2016; 5 (01) 74
• 14 Eardley-Harris N, Munn Z, Cundy PJ, Gieroba TJ. The effectiveness of selective thoracic fusion for treating adolescent idiopathic scoliosis: a systematic review protocol. JBI Database Syst Rev Implement Reports 2015; 13 (11) 4-16
• 15 Byun YM, Iida T, Yamada K. et al. Long-term pulmonary function after posterior spinal fusion in main thoracic adolescent idiopathic scoliosis. PLoS One 2020; 15 (06) e0235123
• 16 Santos HAM, Barsotti CEG. B Junior CAB, Andrade RM, Torini AP, Ribeiro AP. Effect of surgical treatment of scoliotic curvature on the spine and upper limbs. Coluna/Columna 2022; 21 (04) e262464
• 17 Sapriza S, Galli N, Pereyra L, Velasco JM, Rocchietti Á, García F. Long-term follow-up of ais treated surgically with pedicular screws. Coluna/Columna 2021; 20 (02) 132-136
• 18 Grabala P, Helenius IJ, Buchowski JM, Shah SA. The Efficacy of a Posterior Approach to Surgical Correction for Neglected Idiopathic Scoliosis: A Comparative Analysis According to Health-Related Quality of Life, Pulmonary Function, Back Pain and Sexual Function. Children (Basel) 2023; 10 (02) 299
• 19 Zhang HQ, Deng A, Guo CF, Tang MX, Alonge E. Posterior-only surgical correction with heavy halo-femoral traction for the treatment of extremely severe and rigid adolescent idiopathic scoliosis (> 130°). Arch Orthop Trauma Surg 2022; 142 (07) 1317-1324
• 20 Garcia EB, Garcia LF, Garcia Júnior EB. et al. Comparative study of the types of fixation in adolescent idiopathic scoliosis. Coluna/Columna 2021; 20 (01) 14-19
• 21 Dittmar-Johnson HM, Cruz-López F, González-Camacho E. et al. Surgical correction of juvenile idiopathic scoliosis. Our patients' perception of their quality of life. Coluna/Columna 2022; 21 (01) e259475
• 22 Souza AFM, Avila LM, Aguiar CA, Rocha LEM. Pre- and postoperative comparative analysis of the spinopelvic and global sagittal parameters of patients with adolescent idiopathic scoliosis. Coluna/Columna 2022; 21 (01) e250514
• 23 Garcia ASV, Rossoni KM, Steffen R, Zanon IB, Cardoso IM, Jacob Júnior C. Quality of life assessment in patients undergoing surgical treatment for adolescent idiopathic scoliosis, according to the last vertebra instrumented [Internet]. SciELO Preprints. 2021 [cited 2023 May 12]. Available from: https://preprints.scielo.org/index.php/scielo/preprint/view/2940
• 24 Buckland AJ, Woo D, Vasquez-Montes D. et al. The Relationship Between 3-dimensional Spinal Alignment, Thoracic Volume, and Pulmonary Function in Surgical Correction of Adolescent Idiopathic Scoliosis: A 5-year Follow-up Study. Spine 2020; 45 (14) 983-992
• 25 Altaf F, Drinkwater J, Mungovan S. et al. Posterior scoliosis correction with thoracoplasty: effect on pulmonary function with a mean follow-up of 4.8 years. Spine Deform 2022; 10 (04) 825-832
• 26 Benli IT, Ates B, Akalin S, Citak M, Kaya A, Alanay A. Minimum 10 years follow-up surgical results of adolescent idiopathic scoliosis patients treated with TSRH instrumentation. Eur Spine J 2007; 16 (03) 381-391