This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME: Take the activities for this article:
 Spine Test 5: Recent Topics in Spine Surgery
CME 3: July, August, September 2004
Right arrow [Supplementary Material]
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow Rights and Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Sucato, D. J.
Right arrow Articles by Karol, L. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Sucato, D. J.
Right arrow Articles by Karol, L. A.
Related Collections
Right arrow Spine
Right arrow Pediatrics
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Facebook   Add to Technorati   Add to Twitter  
What's this?
The Journal of Bone and Joint Surgery (American) 86:2005-2014 (2004)
© 2004 The Journal of Bone and Joint Surgery, Inc.

Operative Correction of Adolescent Idiopathic Scoliosis in Male Patients

A Radiographic and Functional Outcome Comparison With Female Patients

Daniel J. Sucato, MD, MS1, Daniel Hedequist, MD2 and Lori A. Karol, MD1

1 Department of Orthopaedic Surgery, University of Texas at Southwestern Medical Center, Texas Scottish Rite Hospital, 2222 Welborn Street, Dallas, TX 75230. E-mail address for D.J. Sucato: dan.sucato{at}tsrh.org
2 Department of Orthopaedic Surgery, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115

Investigation performed at Texas Scottish Rite Hospital, Dallas, Texas

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

A video supplement to this article is available from the Video Journal of Orthopaedics. A video clip is available at the JBJS web site, www.jbjs.org. The Video Journal of Orthopaedics can be contacted at (805) 962-3410, web site: www.vjortho.com.

Background: The outcomes following surgical treatment of adolescent idiopathic scoliosis have traditionally been assessed on the basis of radiographic parameters and, more recently, functional outcome measures. However, we know of no published studies in which radiographic and functional outcomes following surgery were compared between male and female patients.

Methods: Fifty-two male patients who had had surgery for adolescent idiopathic scoliosis were compared retrospectively with two groups of female patients: a random sample of 130 female patients who had had surgical treatment for adolescent idiopathic scoliosis during the same time period and a subgroup of fifty-two of these female patients who had been matched to the male patients with regard to curve type and magnitude. Radiographic parameters were compared between the male and female patients, and the Scoliosis Research Society outcome questionnaire was used to compare functional results between the male patients and the matched female group.

Results: Compared with the random sample of female patients, the male patients were older at the time of presentation (average [and standard deviation], 13.9 ± 1.9 compared with 12.8 ± 1.4 years) and at the time of surgery (average, 15.9 ± 2.0 compared with 14.2 ± 1.4 years) (p < 0.05). The male and female patients presented with primary coronal curves of similar magnitudes (average, 48° ± 19° compared with 47° ± 13°), but the male patients had larger curves at the time of surgery (average, 62° ± 11° compared with 56° ± 10°) with greater coronal plane imbalance. Compared with the subset of female patients matched for curve type and magnitude, the male patients had, on average, a longer surgical time (263 ± 61 compared with 202 ± 40 minutes), greater intraoperative blood loss (1148 ± 660 compared with 944 ± 408 mL), and less curve correction in the coronal plane (from 62° ± 11° to 31° ± 11° compared with from 59° ± 10° to 23° ± 9°) (p < 0.05). The loss of coronal plane correction, the final coronal balance, all measured sagittal plane parameters, and the prevalence of complications were the same in these two groups. With regard to functional outcome, the scores were similar with the exception that the male patients had lower scores in the category of "function from back condition" when compared with the matched female patients (3.8 ± 0.2 compared with 4.3 ± 0.3 points) (p < 0.05).

Conclusions: Adolescent idiopathic scoliosis is identified at a later age in male patients than in female patients with similar curve types. The curve magnitudes in the male patients are greater at the time of surgery. When surgeons are planning operative correction of adolescent idiopathic scoliosis in male patients, they should expect longer operative time, greater blood loss, and less coronal plane correction of the primary curve. However, balance in the coronal and sagittal planes should be achieved and complication rates and functional outcomes can be expected to be similar to those in female patients.

Level of Evidence: Prognostic study, Level II-1 (retrospective study). See Instructions to Authors for a complete description of levels of evidence.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Facebook Facebook   Add to Technorati Technorati   Add to Twitter Twitter    What's this?