title: Long-term outcomes of anterior spinal fusion for treating thoracic adolescent idiopathic scoliosis curves: average 15-year follow-up analysis.
abstract: METHODS
  Retrospective review.
  
  
  OBJECTIVE
  To assess the long-term outcomes of anterior spinal fusion (ASF) for treating thoracic adolescent idiopathic scoliosis (AIS).
  
  
  BACKGROUND
  Although ASF is reported to provide good coronal and sagittal correction of the main thoracic (MT) AIS curves, the long-term outcomes of ASF is unknown.
  
  
  METHODS
  A consecutive series of 25 patients with Lenke 1 MT AIS were included. Outcome measures comprised radiographical measurements, pulmonary function, and Scoliosis Research Society outcome instrument (SRS-30) scores (preoperative SRS-30 scores were not documented). Postoperative surgical revisions and complications were recorded.
  
  
  RESULTS
  Twenty-five patients were followed-up for 12 to 18 years (average, 15.2 yr). The average MT Cobb angle correction rate and the correction loss at the final follow-up were 56.7% and 9.2°, respectively. The average preoperative instrumented level of kyphosis was 8.3°, which significantly improved to 18.6° (P = 0.0003) at the final follow-up. The average percent-predicted forced vital capacity and forced expiratory volume in 1 second were significantly decreased during long-term follow-up measurements (73% and 69%; P = 0.0004 and 0.0016, respectively). However, no patient had complaints related to pulmonary function. The average total SRS-30 score was 4.0. Implant breakage was not observed. All patients, except 1 who required revision surgery, demonstrated solid fusion. Late instrumentation-related bronchial problems were observed in 1 patient who required implant removal and bronchial tube repair, 13 years after the initial surgery.
  
  
  CONCLUSIONS
  Overall radiographical findings and patient outcome measures of ASF for Lenke 1 MT AIS were satisfactory at an average follow-up of 15 years. ASF provides significant sagittal correction of the main thoracic curve with long-term maintenance of sagittal profiles. Percent-predicted values of forced vital capacity and forced expiratory volume in 1 second were decreased in this cohort; however, no patient had complaints related to pulmonary function.
authors.affiliation: Department of Orthopaedic Surgery, Hokkaido University, Japan. hidekisudo@yahoo.co.jp
authors.forename: Hideki
authors.initials: H
authors.lastname: Sudo
authors.forename: Manabu
authors.initials: M
authors.lastname: Ito
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Kaneda
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shono
authors.forename: Masahiko
authors.initials: M
authors.lastname: Takahata
authors.forename: Kuniyoshi
authors.initials: K
authors.lastname: Abumi
mesh_terms: D000293:Adolescent; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007738:Kyphosis / Q000601:surgery*; D008297:Male; D063868:Patient Outcome Assessment; D012189:Retrospective Studies; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D011795:Surveys and Questionnaires; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D055815:Young Adult