Long-Term Follow-Up of Ais Treated Surgically With Pedicular Screws

Abstract

Objective: In the last three decades, there have been great advances in the surgical treatment of adolescent idiopathic scoliosis. There are few studies that focus on the long-term clinical and radiographic results of AIS operated on with pedicle screws that also consider psychological repercussions. Methods: We conducted an observational longitudinal study. We reviewed the AIS cases that were operated on with pedicle screws in our center between January 2009 and December 2010. We conducted follow-up until July 2019. A short questionnaire was administered to assess patient satisfaction and the long-term impact from both psychological and functional points of view. Results: A total of 19 patients met the inclusion criteria. The mean preoperative Cobb was 58°, the postoperative was 23° and at the end of follow-up it was 26°. No major complications were reported. Ninety percent were very satisfied with the overall results of the surgery. Ninety-five percent had no limitation for sports or daily activities and 90% were satisfied with the cosmetic results. Conclusion: The short- and long-term radiographic evolution in patients treated with third generation material presented good clinical results. In 3 cases (16%) loss of correction greater than 10% was reported. The overall satisfaction index and cosmetic results were very good at the end of follow-up despite the low correction rate (60%). There were no major complications and the incidence of functional limitation and pain at the end of the follow-up was very low. Level of evidence IV; Review article.

Resultados da abordagem cirúrgica da escoliose idiopática em adolescentes e qualidade de vida pós-operatória: Revisão sistemática de literatura

“…The average correction of the main pathological curvature in the studies was 55.06% AE 12.24 (►Table 1). [15][16][17][18][19][20][21] ►Fig. 2 shows the analysis of the mean correction of the pathological curvature using the pre and postoperative CAs.…”

“…A correção média da curvatura patológica principal nos estudos foi de 55,06% AE 12,24 (►Tabela 1). [15][16][17][18][19][20][21] A ►Fig. 2 representa a análise da correção média da curvatura patológica através dos ACs pré e pós-operatório.…”

“…The average correction of the main pathological curvature in the studies was 55.06% ± 12.24 ( Table 1 ). 15 16 17 18 19 20 21 …”

“…O estudo não abordou qualidade de vida ou função pulmonar associados aos resultados obtidos. 20 Sapriza et al 17 acompanharam 19 pacientes com EIA submetidos à correção cirúrgica por fusão espinhal posterior ao longo de 9,5 anos, com uma média de 10 espaços intervertebrais fundidos por paciente. O valor médio do ângulo pré-operatório foi de 58 (variando de 90-42).…”

“…15 Foram ainda relatadas técnicas de rotação vertebral direta (RVD) associadas à osteotomia tipo 1, 16 Artrodese torácica, artrodese toracolombar e artrodese lombar. 17,22,23 Função Pulmonar Após Intervenção Cirúrgica Para correção da EIA podem ser utilizadas técnicas de fusão posterior ou anterior da coluna vertebral. Embora os dois tipos de abordagem ofereçam correção das curvaturas patológicas, alguns estudos sugerem que a abordagem anterior com toracotomia pode resultar em maior comprometimento da função pulmonar.…”