Abstract
To determine the factors that influences the clinical outcomes in surgical correction of thoracic AIS.
There are conflicting data regarding the effects of back shape and radiologic parameters on the self-reported outcomes of surgery in AIS.
Prospective, cohort study; mean follow-up 29 months (range 9-88)
30 patients (5 males);
Rib hump 17 ° corrected to 7 °.
Thoracic Cobb 66 ° corrected to 25 ° (63%). Lumbar Cobb 42 ° corrected to 17°. Thoracic apical vertebral translation (AVT) 48mm corrected to 18mm. Lumbar AVT 34mm corrected to 19mm. Thoracic kyphosis 29° preoperatively 23° postoperatively. Lumbo-sacral lordosis 57° preoperatively 49° postoperatively
Modified SRS Outcomes Instrument (MSRSI) filled out pre-operatively and at final follow up.
Primary= rib hump, radiological (frontal Cobb correction, lumbar & thoracic AVT, sagittal profile), Modified SRS Outcomes Instrument (MSRSI) domain scores.
The magnitude of the rib hump had a significant association with pain:
Rib hump vs. MSRSI pain r= -0.55 p<0.000
Similar correlations existed between rib hump and self-image (r=-0.64, p<0.0000), thoracic Cobb angle with pain (r=-0.48 p<0.0001) and self-image (r= -0.57, P<0.0000). The postoperative thoracic Cobb angle, and percentage thoracic Cobb correction had significant correlations with self-image (r=-0.55 p=0.003 & r=0.54 p0.004 respectively).
The size of the rib hump has a significant impact on pain & self-image. These domains are also significantly influenced by the residual thoracic Cobb angle and overall scoliosis correction.
