Factors influencing the quality of life following posterior approach surgical treatment in adolescents with idiopathic scoliosis: A 2-year follow-up study.

Abstract

Surgical intervention is the preferred approach to prevent further progression of deformity for patients with adolescent idiopathic scoliosis (AIS); among existing surgeries, posterior spinal fusion is predominant. The minimal clinically important difference (MCID) of the total score of the Scoliosis Research Society (SRS)-22r questionnaire is an increase of ≥ 0.4 in surgically treated patients. However, to the best of our knowledge, there is no research exploring the factors influencing SRS-22r total scores exceeding MCID at 2 years postoperatively. Patients who underwent posterior spinal fusion between February 2019 and November 2023 and had a minimum follow-up duration of > 2 years were included. The radiological data and SRS-22r scores were assessed preoperatively and postoperatively. Based on the SRS-22r total scores, the patients were divided into two groups: ‘I’ = Improvement group (∆ Score ≥ 0.4) and ‘NI’ = Non-improvement group (∆ Score < 0.4). Demographic characteristics, radiographic data, and SRS-22r scores were analyzed using chi-square tests and t-tests for comparison. Multivariate logistic regression analysis was used to determine influencing factors. A total of 66 patients with AIS underwent posterior spinal fusion surgery were included in the study. The major Cobb angle decreased from 52.9 ± 12.3° preoperatively to 12.3 ± 8.6° (<i>p</i> < 0.001) at 2 years postoperatively, while the SRS-22r total score improved from 3.9 ± 0.4 to 4.2 ± 0.5 (<i>p</i> < 0.001). Overall, 32 of 66 of patients (48.5%) achieved MCID. Preoperatively, the Improvement group trended toward a larger Cobb angle (<i>p</i> = 0.042). Postoperatively, patients who achieved a greater Cobb angle correction in degrees were more likely to attain the MCID (<i>p</i> = 0.003). Postoperative MCID attainment in patients with AIS is influenced by both the preoperative Cobb angle and the degree of its surgical correction. The online version contains supplementary material available at 10.1186/s13018-025-06225-w.