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Purpose <p>The complex relationship between spine deformity and self-image is incompletely understood. This study aims to evaluate how age affects self-image in idiopathic scoliosis.</p> Methods <p>Single-center study of adult (AdIS) and adolescent (AIS) idiopathic scoliosis patients treated with posterior spinal fusion (PSF). Preoperative and two-year postoperative patient-reported, radiographic, and perioperative outcomes were compared. Patients were grouped according to age, AIS (&lt; 1 8&#xa0;years), young adults (yAdIS, 18–40&#xa0;years) and older adults (oAdIS, &gt; 40&#xa0;years).</p> Results <p>176 patients were included, 54 AIS (ave. 15.8&#xa0;years), 47 yAdIS (mean 25.2&#xa0;years), and 74 oAdIS (mean 56.5&#xa0;years). Preoperative curve magnitude was similar between groups (<i>p</i> = 0.0863). Postoperative, AIS and yAdIS had similar curves, but smaller than oAdIS (<i>p</i> = 0.0104) with similar corrections (<i>p</i> = 0.6476). AIS had lower EBL (<i>p</i> &lt; 0.0001), shorter OR times (<i>p</i> &lt; 0.0001), fewer levels (<i>p</i> &lt; 0.0001) and pelvic instrumentation (<i>p</i> &lt; 0.0001). AIS had greater preoperative self-image scores (3.5 vs. 3.1 vs. 2.5, <i>p</i> &lt; 0.0001) with no difference seen postoperative (4.4 vs. 4.3 vs. 4.2, <i>p</i> = 0.1230). However, the greatest improvement was observed in oAdIS patients (<i>p</i> &lt; 0.0001). Independent predictors of self-image scores varied by age and included anxiety/depression (<i>β</i> = − 1.057), BMI (<i>β</i> = 0.033), and postoperative CVA (<i>β</i> = − 0.021) for AIS; anxiety/depression (<i>β</i> = − 0.513) and curve correction (<i>β</i> = 0.0143) in yAdIS; and postoperative pelvic tilt (<i>β</i> = − 0.028, <i>p</i> = 0.0037) for oAdIS.</p> Conclusion <p>AIS patients had the highest preoperative self-image scores, followed by yAdIS and then oAdIS. However, the greatest improvement was observed in the older patients, despite more surgical morbidity. Mental health diagnoses were associated with worse self-image scores in AIS and yAdIS, though not oAdIS.</p>

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Older adult idiopathic scoliosis patients have greater improvement in self-image compared to younger adult and adolescent idiopathic scoliosis patients following posterior spinal fusion

  • 期刊论文

  • 发表日期：

    2025年8月26日

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  • Taylor J. Jackson,
  • Fthimnir M. Hassan,
  • Matthew Weintraub,
  • Omar Taha,
  • Mehdi Elfilali,
  • Edwin Kulubya,
  • Erik Lewerenz,
  • Justin L. Reyes,
  • Riley Sevensky,
  • Josephine R. Coury,
  • Andrew Zhang,
  • Michael J. Strong,
  • Joseph M. Lombardi,
  • Zeeshan M. Sardar,
  • Ronald A. Lehman,
  • Lawrence G. Lenke

摘要

Purpose

The complex relationship between spine deformity and self-image is incompletely understood. This study aims to evaluate how age affects self-image in idiopathic scoliosis.

Methods

Single-center study of adult (AdIS) and adolescent (AIS) idiopathic scoliosis patients treated with posterior spinal fusion (PSF). Preoperative and two-year postoperative patient-reported, radiographic, and perioperative outcomes were compared. Patients were grouped according to age, AIS (< 1 8 years), young adults (yAdIS, 18–40 years) and older adults (oAdIS, > 40 years).

Results

176 patients were included, 54 AIS (ave. 15.8 years), 47 yAdIS (mean 25.2 years), and 74 oAdIS (mean 56.5 years). Preoperative curve magnitude was similar between groups (p = 0.0863). Postoperative, AIS and yAdIS had similar curves, but smaller than oAdIS (p = 0.0104) with similar corrections (p = 0.6476). AIS had lower EBL (p < 0.0001), shorter OR times (p < 0.0001), fewer levels (p < 0.0001) and pelvic instrumentation (p < 0.0001). AIS had greater preoperative self-image scores (3.5 vs. 3.1 vs. 2.5, p < 0.0001) with no difference seen postoperative (4.4 vs. 4.3 vs. 4.2, p = 0.1230). However, the greatest improvement was observed in oAdIS patients (p < 0.0001). Independent predictors of self-image scores varied by age and included anxiety/depression (β = − 1.057), BMI (β = 0.033), and postoperative CVA (β = − 0.021) for AIS; anxiety/depression (β = − 0.513) and curve correction (β = 0.0143) in yAdIS; and postoperative pelvic tilt (β = − 0.028, p = 0.0037) for oAdIS.

Conclusion

AIS patients had the highest preoperative self-image scores, followed by yAdIS and then oAdIS. However, the greatest improvement was observed in the older patients, despite more surgical morbidity. Mental health diagnoses were associated with worse self-image scores in AIS and yAdIS, though not oAdIS.