Long-term Life-Quality Outcomes after Corrective Adolescent Idiopathic Scoliosis Surgery: 10-Year Postoperative Assessment Comparing Lenke Classification and Fused Levels.

Background

Adolescent idiopathic scoliosis (AIS) is a complex spinal deformity often requiring surgical correction in progressive cases. While posterior spinal fusion (PSF) is the standard treatment, long-term outcomes beyond 10 years and the impact of Lenke classification and fusion length on patients' quality of life remain underexplored. This study aims to evaluate the 10-year postoperative outcomes of AIS patients treated with PSF, comparing results across different Lenke curve types and fusion lengths.

Methods

This retrospective study with a minimum follow-up of 10 years analyzed a cohort of 98 AIS patients who underwent PSF. Those with neuromuscular, congenital, or syndromic scoliosis were excluded. Outcomes included radiographic parameters and patient-reported metrics: SRS-22, SF-36 and Oswestry disability index (ODI). Subgroup analyses were performed based on Lenke classification and number of vertebrae fused.

Results

Patients showed excellent long-term outcomes, with a mean SRS-22 total score of 4.5, SF-36 physical and mental scores above population norms and a mean ODI of 5.6%, indicating minimal disability. Lenke 1 patients (single thoracic curves) had superior outcomes in pain, satisfaction and total SRS-22 scores compared to those with more complex curves. Shorter fusions (≤nine levels) were associated with better function, self-image and lower disability, without compromising satisfaction or pain relief.

Conclusion

Posterior spinal fusion in AIS yields durable improvements in function, pain and quality of life after 10 years. Shorter fusion constructs and simpler curve patterns are linked to slightly better outcomes, supporting selective fusion strategies when appropriate. These findings underscore the value of individualized surgical planning based on curve characteristics and motion preservation, while integrating modern technologies and AI models to further improve inter-reliability, decision making and patients' quality of life.