Journal of Research in Orthopedic Science

en Is Surgery Justified for AIS Patients with Cobb Angles Under 40 Degrees? A Retrospective Analysis of Clinical and Radiologic Outcomes ستون فقرات Spine surgery پژوهشی Research Article 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.   Adolescent Idiopathic Scoliosis, Posterior Spinal Fusion, Scoliosis Surgery, SRS-22r questionnaire, Patient-Reported Outcome Measures, Self-Image 0 0 http://jros.iums.ac.ir/browse.php?a_code=A-10-2742-2&slc_lang=en&sid=1 Mohammadreza Chehrassan morchehrasan@yahoo.com 10031947532846008920 10031947532846008920 No Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Farshad Nikoue nikouei.f@iums.ac.ir 10031947532846008921 10031947532846008921 No Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Mohammadreza Shakeri mshakeri3116@gmail.com 10031947532846008922 10031947532846008922 No Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Seyed Matin Sadat Kiaei matin.sk2@gmail.com 10031947532846008923 10031947532846008923 No Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Saba Falakeh sabafalakehh@gmail.com 10031947532846008924 10031947532846008924 No Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Ehsan Ghavidel ghavidele@gmail.com 10031947532846008925 10031947532846008925 Yes Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Ebrahim Ameri Mahabadi ameri.e@iums.ac.ir 10031947532846008926 10031947532846008926 No Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Hasan Ghandhari ghandehari.h@iums.ac.ir 10031947532846008927 10031947532846008927 No Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.