A1 Refereed original research article in a scientific journal
Association Between Lenke Classification, The Extent of Lumbar Spinal Fusion, and Health-Related Quality of Life After Instrumented Spinal Fusion for Adolescent Idiopathic Scoliosis
Authors: Frantzén Aron, Suominen Eetu N., Saarinen Antti J., Ponkilainen Ville, Syvänen Johanna, Helenius Linda, Ahonen Matti, Helenius Ilkka
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Publication year: 2023
Journal: Spine
Journal name in source: SPINE
Journal acronym: SPINE
Volume: 48
Issue: 17
First page : 1216
Last page: 1223
Number of pages: 8
ISSN: 0362-2436
eISSN: 1528-1159
DOI: https://doi.org/10.1097/BRS.0000000000004760(external)
Web address : https://journals.lww.com/spinejournal/fulltext/2023/09010/association_between_lenke_classification,_the.4.aspx(external)
Study Design.
Prospective cohort study.
Summary of Background Data.
Lenke classification is used to define the curve type in adolescent idiopathic scoliosis (AIS). The association of Lenke classification and long-term postoperative health-related quality of life (HRQoL) remains unclear.
Objective.
The purpose of this study was to assess the association between Lenke classification and HRQoL in patients who underwent spinal fusion for AIS.
Materials and Methods.
In all, 146 consecutive patients (mean age 15.1 yr) operated for AIS between 2007 and 2019 with a minimum 2-year follow-up were included. Fifty-three (36%) patients reached the 10-year follow-up. Their HRQoL was assessed with the SRS-24 questionnaire preoperatively, at six months, two years, and 10 years after surgery.
Results.
The preoperative major curve was the largest in Lenke 3 (mean 63°) and 4 (mean 62°) groups and the lowest in Lenke 5 groups (mean 48°, P<0.05). These curves were corrected to a mean of 15° with no differences between groups. We found no evidence of differences between the preoperative HRQoL scores between the Lenke groups. The self-image domain of SRS-24 was lower in patients with isolated major thoracolumbar scoliosis (Lenke 5) when compared with double-thoracic (Lenke 2) group at the two-year follow-up (mean [95% CI] 3.6 [3.3-3.9] vs. 4.3 [4.1-4.6]). The postoperative satisfaction domain was lower in Lenke 5 group when compared with main thoracic (Lenke 1) group (mean [95% CI] 3.8 [3.5-4.0] vs. 4.3 [4.2-4.5]) and Lenke 2 group (mean 4.4, 95% CI 4.2-4.6) at the two-year follow-up. The mean total score of SRS-24 at the 10-year follow-up was highest in Lenke 1 group (mean 4.06, 95% CI 3.79-4.33) and lowest in Lenke 6 group (mean 2.92, 95% CI 2.22-3.61).
Conclusions.
Lenke classification and especially its curve type (major thoracic vs. major thoracolumbar scoliosis) was associated with long-term health-related quality of life after instrumented spinal fusion for AIS.
