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- Title
A Risk Quantification Reference Table for Progressed Adolescent Idiopathic Scoliosis Surgery: An Exact Case Matched Outcomes Analysis.
- Authors
Liu, Gabriel; Tan, Jun-Hao; Fung, Gerald; Hui, Sijian; Lau, Leok Lim; Chan, Yiong Huak; Wong, Hee-Kit
- Abstract
Study Design: Retrospective Exact Matched case-control study Objectives: Surgical treatment delay in AIS due to family preferences is common. This study aims to quantify the increase in risks as the Cobb angle increases and provide a Quantifiable Risk Reference Table that can be utilized for counseling. Methodology: AIS patients were divided into 3 groups: Group A: Cobb angle 50–60°, Group 61–70°, and Group CFinal ≥80°. Each patient in Group CFinal who had curve progression were then traced-back-in-time (TBIT) to review the clinical data at earlier presentations at 50–60° (C1), and 61–70° (C2). Patient demographics, radiological, operative, and outcomes data were compared between Group A vs C1 and Group B vs Group C2. Results: A total of 614 AIS surgeries were reviewed. Utilizing the EM technique, a total of 302 AIS patients were recruited. There were 147, 111, 31, and 32 patients matched in Groups A, B, C1, and C2, respectively. C2 Final patients had 34% curve pattern change, 23.2% higher incidence of requiring two surgeries, and 17.3% increase in complications. There was a statistically significant increase of 2.4 spinal levels fused, 12% increase in implant density, 35% increase in operative time, 97% increase in intra-operative blood loss, 10% loss of scoliosis correction, 40% longer hospitalization stay, and 36% increase in costs for patients who had curve progression. Conclusion: This study is the first to use a homogenously matched AIS cohort to provide a Quantifiable Risk Reference Table. The Risk Table provides essential knowledge for treating physicians when counseling AIS patients.
- Subjects
ADOLESCENT idiopathic scoliosis; ORTHOPEDIC braces; SPINAL implants; TREATMENT delay (Medicine)
- Publication
Global Spine Journal, 2023, Vol 13, Issue 8, p2228
- ISSN
2192-5682
- Publication type
Article
- DOI
10.1177/21925682221079262