Volume 13, Issue 2 (Spring- In press 2026)
JROS 2026, 13(2): 0-0 |
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Chehrassan M, Nikoue F, Shakeri M, Kiaei S M S, Falakeh S, Ghavidel E, et al . Is Surgery Justified for AIS Patients with Cobb Angles Under 40 Degrees? A Retrospective Analysis of Clinical and Radiologic Outcomes. JROS 2026; 13 (2)
URL: http://jros.iums.ac.ir/article-1-2319-en.html
URL: http://jros.iums.ac.ir/article-1-2319-en.html
Mohammadreza Chehrassan1 
, Farshad Nikoue1 , Mohammadreza Shakeri1 , Seyed Matin Sadat Kiaei1 , Saba Falakeh1 , Ehsan Ghavidel1 , Ebrahim Ameri Mahabadi1 , Hasan Ghandhari1
, Farshad Nikoue1 , Mohammadreza Shakeri1 , Seyed Matin Sadat Kiaei1 , Saba Falakeh1 , Ehsan Ghavidel1 , Ebrahim Ameri Mahabadi1 , Hasan Ghandhari1
1- Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Abstract: (2 Views)
Background: Surgical intervention in adolescent idiopathic scoliosis (AIS) is typically reserved for patients with curves exceeding 45°, leaving those with moderate curves often managed conservatively. This study evaluates the clinical and radiologic outcomes of posterior spinal fusion (PSF) in AIS patients with preoperative moderate scoliotic curves, with a particular focus on patient-reported outcomes.
Methods: This retrospective cohort study was conducted at a single tertiary hospital. AIS patients aged 10 to 20 years with preoperative Cobb angles between 35° and 45° who underwent PSF were included. Radiologic parameters and quality of life were assessed preoperatively and at least one year postoperatively using anterior-posterior and lateral total spine X-rays in standing position and the SRS-22r questionnaire. Statistical analysis was performed using SPSS software.
Results: 40 patients were included (36 females, 4 males) with a mean age of 15.58 ± 2.76 years. The mean thoracic and thoracolumbar Cobb angles decreased significantly postoperatively (p < 0.001). While changes in other radiologic parameters were limited, patients demonstrated significant improvement in overall SRS22r scores (from 3.59 ± 0.65 to 3.98 ± 0.54, p < 0.001), particularly in the self-image (p = 0.008), function (0.001), and satisfaction with management (P<0.001) domains. No significant differences were observed based on prior bracing, fusion type, gender, or Lenke classification.
Conclusion: AIS patients with moderate curves may benefit from surgical correction in terms of improved self-image and satisfaction, even when radiographic changes are limited. These findings highlight the importance of incorporating patient-reported outcomes in surgical decision-making for this underrepresented group.
Methods: This retrospective cohort study was conducted at a single tertiary hospital. AIS patients aged 10 to 20 years with preoperative Cobb angles between 35° and 45° who underwent PSF were included. Radiologic parameters and quality of life were assessed preoperatively and at least one year postoperatively using anterior-posterior and lateral total spine X-rays in standing position and the SRS-22r questionnaire. Statistical analysis was performed using SPSS software.
Results: 40 patients were included (36 females, 4 males) with a mean age of 15.58 ± 2.76 years. The mean thoracic and thoracolumbar Cobb angles decreased significantly postoperatively (p < 0.001). While changes in other radiologic parameters were limited, patients demonstrated significant improvement in overall SRS22r scores (from 3.59 ± 0.65 to 3.98 ± 0.54, p < 0.001), particularly in the self-image (p = 0.008), function (0.001), and satisfaction with management (P<0.001) domains. No significant differences were observed based on prior bracing, fusion type, gender, or Lenke classification.
Conclusion: AIS patients with moderate curves may benefit from surgical correction in terms of improved self-image and satisfaction, even when radiographic changes are limited. These findings highlight the importance of incorporating patient-reported outcomes in surgical decision-making for this underrepresented group.
Keywords: Adolescent Idiopathic Scoliosis, Posterior Spinal Fusion, Scoliosis Surgery, SRS-22r questionnaire, Patient-Reported Outcome Measures, Self-Image
Type of Study: Research Article |
Subject:
Spine surgery
Received: 2026/05/3 | Accepted: 2026/05/4 | Published: 2026/07/19
Received: 2026/05/3 | Accepted: 2026/05/4 | Published: 2026/07/19
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