AB218. SOH25_AB_127. How straight does the spine need to be after spinal fusion in patients with adolescent idiopathic scoliosis?—A systematic review
Orthopaedic Posters

AB218. SOH25_AB_127. How straight does the spine need to be after spinal fusion in patients with adolescent idiopathic scoliosis?—A systematic review

Yi Jan Lim1, Oliver Boughton2, Paul Connolly2, Damian McCormack2, Nicola Fay3

1Faculty of Education & Health Services, School of Medicine, University of Limerick, Garraun, Castletroy, Limerick, Ireland; 2National Orthopaedic Hospital, Cappagh, Dublin, Ireland; 3Research & Education Centre Library, Midland Regional Hospital, Tullamore, Co. Offaly, Ireland

Background: Adolescent idiopathic scoliosis (AIS) is a 3-dimensional lateral curvature of the spine where spinal manipulation with fusion provides definitive correction. The literature remains unclear to what post-operative coronal Cobb angle is acceptable. The objective of this systematic study is to determine if there is a consensus opinion on an acceptable maximal coronal Cobb angle after posterior spinal fusion.

Methods: A systematic review of published literature in EBSCO and PubMed, using Preferred Reporting Items or Systematic Reviews and Meta-Analyses guidelines, was performed between 2010–2024 to aim to determine if a preferred post-operative coronal alignment was commented on and to identify post-operative coronal Cobb angles in AIS patients who underwent posterior fusion surgery. Papers not specific to AIS, no fusion surgery and absent preoperative and postoperative corrective angles were excluded

Results: A total of 7 prospective and 21 retrospective studies met the inclusion criteria involving 2,840 patients. The 28 studies were subdivided according to their Lenke subclassifications as Lenke 1-2, Lenke 1-6 or Lenke 5 with post-operative corrective angles to 15°, 19° and 10°, respectively. Percentage corrective angles varied ranging from 54% to 95%.

Conclusions: Posterior spinal fusion balances between getting a satisfactory correction, reducing blood loss, surgical time and risk to the spinal cord from aiming for over-correction. The published literature suggests a residual post-fusion coronal Cobb angle of <20° can be safely aimed for when utilising modern surgical approaches. Further prospective studies are required to determine if variation in postoperative corrective angles result in the differences in quality of life in patients with AIS.

Keywords: Adolescent idiopathic scoliosis (AIS); posterior spinal fusion surgery; Lenke subclassification; post-operative corrective angle; systematic review

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab218
Cite this abstract as: Lim YJ, Boughton O, Connolly P, McCormack D, Fay N. AB218. SOH25_AB_127. How straight does the spine need to be after spinal fusion in patients with adolescent idiopathic scoliosis?—A systematic review. Mesentery Peritoneum 2025;9:AB218.

Article Options

Download Citation

Share