Study design:

Prospective cohort study.

Summary of background data:

Lenke classification is used to define the curve type in adolescent idiopathic scoliosis (AIS). Association of Lenke classification and long-term postoperative health-related quality of life (HRQoL) remains unclear.

Objective:

The purpose of this study was to assess the association between Lenke classification and HRQoL in patients who underwent spinal fusion for AIS.

Materials and methods:

In all, 146 consecutive patients (mean age 15.1 y) operated for AIS between 2007-2019 with minimum 2-year follow-up were included. Fifty-three (36%) patients reached the 10-year follow-up. Their HRQoL was assessed with SRS-24 questionnaire preoperatively, at 6 months, 2 years, and 10 years after surgery.

Results:

The preoperative major curve was largest in Lenke 3 (mean 63°) and 4 (mean 62°) groups, and lowest in Lenke 5 group (mean 48°, P<0.05). These curves were corrected to a mean of 15° with no differences between groups. We found no evidence of differences between the preoperative HRQoL scores between the Lenke groups. Self-image domain of SRS-24 was lower in patients with isolated major thoracolumbar scoliosis (Lenke 5) when compared to double-thoracic (Lenke 2) group at the 2-year follow-up (mean [95%CI] 3.6 [3.3-3.9] vs. 4.3 [4.1-4.6]). The postoperative satisfaction domain was lower in Lenke 5 group when compared to main thoracic (Lenke 1) group (mean [95%CI] 3.8 [3.5-4.0] vs. 4.3 [4.2-4.5]) and Lenke 2 group (mean 4.4, 95%CI 4.2-4.6) at the 2-year follow-up. The mean total score of SRS-24 at the 10-year follow-up was highest in Lenke 1 group (mean 4.06, 95% CI 3.79-4.33) and lowest in Lenke 6 group (mean 2.92, 95% CI 2.22-3.61).

Conclusion:

Lenke classification and especially its curve type (major thoracic vs. major thoracolumbar scoliosis) was associated with long-term health-related quality of life after instrumented spinal fusion for AIS.