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HEIGHT CHANGE FOLLOWING CORRECTIVE SURGERY FOR ADOLESCENT IDIOPATHIC SCOLIOSIS

British Association of Spinal Surgeons (BASS)



Abstract

Introduction

A common question posed by adolescents undergoing corrective scoliosis surgery is, “How much taller will I be after my operation?” This study aims to help answer this question, and quantify the gain in height that might be expected.

Method

Retrospective data was collected on 68 consecutive surgeries for adolescent idiopathic scoliosis (AIS). Data collected includes age, gender, height, Cobb angle and curve type (Lenke / King classifications). All cases had AIS and were treated by posterior instrumented fusion. Exclusion criteria were neuromuscular/syndromic conditions, anterior approach or revision surgery. Post-operative X-rays were assessed between 1 week and 1 year after surgery.

Results

The median age of the cohort was 15 years (range 12-17). There were 61 females and 7 males. Lenke type 1B was the most common curve (37%). All patients gained height post-operatively. The median gain in height, as a percentage of pre-operative height was 5.5% (range 0.5 – 21.4%). There was a statistically significant difference (p<0.001) between change in height and Lenke type (see figure). There was a progressive increase with a median gain in height in Lenke 1A of 3.4% up to 14.9% in a Lenke 6 curve. Surprisingly, this trend was not reproducible with the King's classification.

There was no significant relationship of change in height with either gender or age, but the pre operative Cobb angle had a moderate correlation (r=-0.65, p<0.001) with the change in Cobb angle.

In 44 patients who had x-rays at 6 months – 1 year, all showed continued growth. This was significantly greater (p=0.04) in the patients aged 12 and 13.

Conclusion

This study provides useful information for patients undergoing AIS surgery as to expected height gain based on their pre-operative Lenke grade. King's classification however does not show a similar trend with change in height.