Article

INTRODUCTION: To date there is no consensus on therapeutic indications in
adolescent idiopathic scoliosis (AIS) with curvature between 30 degrees and 60
degrees at the end of growth. The objective of this study was to
assess outcome in patients with moderate AIS.
METHODS: A multicenter
retrospective study was conducted. Inclusion criteria were: Cobb angle, 30-60
degrees at end of growth; and follow-up > 20 years. The data collected were
angular values in adolescence and at last follow-up, and quality of life scores
at follow-up. RESULTS: A total of 258 patients were enrolled: 100 operated on in
adolescence, 116 never operated on, and 42 operated on in adulthood. Mean
follow-up was 27.8 years. Cobb angle progression significantly differed between
the 3 groups: 3.2 degrees versus 8.8 degrees versus 23.6 degrees , respectively;
P < 0.001. In lumbar scoliosis, the risk of progression to >/= 20 degrees was
significantly higher for initial Cobb angle > 35 degrees (OR=4.278, P=0.002).
There were no significant differences in quality of life scores. DISCUSSION:
Patients operated on in adolescence showed little radiological progression,
demonstrating the efficacy of surgical treatment for curvature greater than 50
degrees . Curvature greater than 40 degrees was progressive and may require
surgery in adulthood. Lumbar scoliosis showed greater potential progression than
thoracic scoliosis in adulthood, requiring fusion as of 35 degrees angulation.
LEVEL OF EVIDENCE: IV, retrospective study.
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Langue : FRANCAIS