2021 Volume 12 Issue 9 Pages 1117-1123
Introduction: The aim of this study was to clarify the radiological risk factors for a late revision surgery in patients with postoperative adolescent idiopathic scoliosis (AIS) with a long-term follow-up.
Methods: A total of 47 adult patients who underwent spinal fusion surgery for the correction of scoliosis in adolescents with a minimum follow-up of 10 years were retrospectively evaluated. The radiographical parameters were compared between patients who underwent late (at least 10 years postoperatively) revision surgery and those who did not.
Results: Revision surgeries were performed in nine patients with a mean time to revision of 21.9 years after the initial surgery. Postoperative radiological parameters before revision surgeries or at last follow-up, including pelvic tilt, lumbar lordosis, sagittal vertical axis, coronal balance, L3 and L4 tilt, and apical vertebral translation were 32.0°, 22.1°, 11.3 mm, 37.7 mm, 14.4°, 18.2°and 42.1 mm in patients with revision surgeries and 19.7°, 43.6°, 0.8 mm, 4.7 mm, 8.0°, 8.3°and 24.7 mm in those without revision surgeries, respectively, with statistical differences (P < 0.05).
Conclusions: We demonstrated significant radiological risk factors for a late revision surgery, including increases in coronal off-balance, pelvic tilt, L3 and L4 tilt, and a decrease in lumbar lordosis. Maintaining a less lumbar tilt and well-balanced sagittal and coronal alignment should be considered for better long-term postoperative clinical outcomes in patients with AIS.
