Predictive factors for correction rate in severe idiopathic scoliosis (Cobb angle ≥ 90°): an analysis of 128 patients

European Spine Journal (2021)Cite this article

Abstract

Purpose

Knowledge on the factors affecting the correction rate (CR) aids in the surgical planning among severe idiopathic scoliosis (IS) patients. This study aimed to investigate the independent factors affecting CR among patients with severe IS (Cobb angle ≥ 90°) who underwent single-staged posterior spinal fusion (PSF).

Methods

We retrospectively reviewed 128 severe IS patients who underwent single-staged PSF. Factors including age, height, weight, body mass index, Risser sign, Lenke subtypes, preoperative major Cobb angle, side bending major Cobb angle, side bending flexibility (SBF), motion segments of the major curve, AR curve, number of levels fused, screw density, operative time and postoperative major Cobb angle were analysed using linear regression analysis.

Results

The mean age was 15.5 ± 4.5 years with mean Risser sign of 3.1 ± 1.6. The mean preoperative Cobb, SBF, postoperative Cobb and CR were 102.8 ± 12.3°, 37.5 ± 13.7%, 44.4 ± 13.5° and 57.2 ± 10.8%, respectively. From stepwise multiple linear regression analysis, SBF, Risser sign and AR curve were the independent predictive factors for CR, with R2 value of 0.345 (p < 0.001). CR can be predicted using the formula: 47.21 + (0.34 × SBF)–(1.47 × Risser sign) + (3.69 × AR), where AR = 1 and non-AR = 0.

Conclusion

The flexibility of the major curve, Risser sign and AR curve were the most important predictors for CR in a single-staged PSF among patients with severe IS.

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Affiliations

  1. Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia

    Yuki Mihara, Weng Hong Chung, Siti Mariam Mohamad, Chee Kidd Chiu, Chris Yin Wei Chan & Mun Keong Kwan

  2. Department of Orthopaedic Surgery, Hamamatsu University, School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu-shi, Shizuoka, Japan

    Yuki Mihara

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  1. Yuki Mihara
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  2. Weng Hong Chung
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Correspondence to Mun Keong Kwan.

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Mihara, Y., Chung, W.H., Mohamad, S.M. et al. Predictive factors for correction rate in severe idiopathic scoliosis (Cobb angle ≥ 90°): an analysis of 128 patients. Eur Spine J (2021). https://doi.org/10.1007/s00586-020-06701-3

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Keywords

  • Severe scoliosis
  • Correction rate
  • Predictive factor
  • Posterior spinal fusion
  • Side bending flexibility
  • Risser sign