The relationship between deformity correction and clinical outcomes after thoracoscopic scoliosis surgery: a prospective series of one hundred patients.
METHODS
Prospective clinical case series of 100 patients receiving thoracoscopic anterior scoliosis correction.


OBJECTIVE
To evaluate the relationship between clinical outcomes of thoracoscopic anterior scoliosis surgery and deformity correction, using the Scoliosis Research Society (SRS) outcomes instrument.


BACKGROUND
Surgical treatment of scoliosis is quantitatively assessed in the clinic, using radiographic measures of deformity correction and the rib hump, but it is important to understand the extent to which these quantitative measures correlate with self-reported improvements in patients' quality of life after surgery.


METHODS
A series of 100 consecutive adolescent idiopathic scoliosis patients received a single anterior rod via a thoracoscopic approach at the Mater Children's Hospital, Brisbane, Australia. Patients completed SRS outcomes questionnaires before surgery and at 24 months after surgery. Multiple regression and t tests were used to investigate the relationship between SRS scores and deformity correction achieved (radiographic measurements and rib hump) after surgery.


RESULTS
There were 94 females and 6 males with a mean age of 16.1 years. The mean Cobb angle improved from 52° before surgery to 25° after surgery (52%) and the mean rib hump improved from 16° to 8° (51%). The mean total SRS score for the cohort was 99.4/120. None of the deformity-related parameters in the multiple-regression were significant. However, patients with the lowest postoperative major Cobb angles reported significantly higher SRS scores than those with the highest postoperative Cobb angles, but there was no difference on the basis of rib hump correction. There were no significant differences between patients with either rod fractures or screw-related complications compared to those without complications.


CONCLUSIONS
Patients undergoing thoracoscopic anterior scoliosis correction reported good SRS scores which are comparable with those in previous studies. Postoperative major Cobb angle is a significant predictor of patient satisfaction when comparing subgroups of patients with the highest and lowest postoperative Cobb angles.
Izatt
Maree T
MT
Paediatric Spine Research Group, Queensland University of Technology and Mater Health Services Brisbane Ltd, Queensland, Australia.
Adam
Clayton J
CJ
Labrom
Robert D
RD
Askin
Geoffrey N
GN
D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D002648:Child; D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011859:Radiography; D012044:Regression Analysis; D012600:Scoliosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D013906:Thoracoscopy / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult