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Selective Thoracic Fusion for Adolescent Idiopathic Scoliosis: Long-Term Radiographic and Functional Outcomes
1Twin Cities Spine Center, 913 E 26th Street, Suite 600, Minneapolis, MN 55404, USA; Gillette Children's Specialty Healthcare, 200 University Ave E, St Paul, MN 55101, USA.
Spine Deformity
|October 24, 2018
Summary
Selective thoracic fusions (STFs) provide stable long-term outcomes for thoracic scoliosis. Patients maintain good function and show minimal lumbar spine degeneration decades after surgery.
Area of Science:
- Orthopedics
- Spinal Surgery
- Scoliosis Treatment
Background:
- Selective thoracic fusions (STFs) were developed for thoracic scoliosis with a flexible lumbar curve.
- Long-term behavior and patient function after STF beyond 20 years remain unclear.
Purpose of the Study:
- To evaluate the long-term (average 33 years) radiographic and functional outcomes of patients who underwent selective thoracic fusions.
Main Methods:
- Retrospective review of 40 patients with STF who completed outcome questionnaires (ODI, SRS-30) and had follow-up radiographs.
- Analysis of preoperative, postoperative, and long-term follow-up films for curve progression and lumbar spine degeneration.
Main Results:
- Average follow-up was 32.7 years. Lumbar curves remained stable postoperatively.
- Patients reported good functional outcomes (ODI 8.7, SRS-30 3.8).
- Mild lumbar radiographic changes (disc space narrowing, osteophytes) were observed, not correlating with disability.
Conclusions:
- Selective thoracic fusion leads to stable lumbar curves and good patient function at an average of 33 years post-surgery.
- Mild degenerative changes in the lumbar spine are common but do not significantly impact patient outcomes.
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