• Takahiro Iida, Nobumasa Suzuki, Katsuki Kono, Yasumasa Ohyama, Jyunya Imura, Akihisa Ato, Satoru Ozeki, and Yutaka Nohara.
• *Department of Orthopaedic Surgery, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan †Scoliosis Center, Saiseikai Central Hospital, Tokyo, Japan ‡Department of Orthopaedic Surgery, Saiseikai Kanagawa-ken Hospital, Yokohama, Japan; and §Department of Orthopaedic Surgery, Dokkyo Medical University, Mibu-machi, Japan.
• Spine. 2015 Aug 15; 40 (16): E922-8.

Study DesignA retrospective minimum 20-year follow-up study using 4 standard self-administered questionnaires, one of which, the SRS-22 was also administered to control groups.ObjectiveTo evaluate long-term postoperative pain and other clinical outcomes of scoliosis correction and fusion surgery with Harrington instrumentation using Moe square-ended rods for better preservation of sagittal alignment.Summary Of Background DataOnly a few long-term outcome studies have used standardized and validated self-administered tools, and no studies have established SRS-22 control data within their own population. There is no previous minimum 20-year follow-up evaluation after correction surgery preserving thoracic kyphosis and lumbar lordosis.MethodsOf 86 consecutive patients who underwent instrumentation surgery for scoliosis by a single surgeon, 61 patients participated using Japanese Orthopaedic Association, Roland-Morris Disability Questionnaire, Oswestry Disability Index, and Scoliosis Research Society (SRS-22) questionnaires and 51 patients were included in this study. Results were analyzed for pain and other clinical outcomes. A total of 771 hospital employees were sent SRS-22 questionnaires. A total of 763 responded, resulting in 2 control groups composed of nonscoliosis and untreated mild scoliosis controls of the same culture and language as the long-term follow-up group.ResultsThe prevalence of continuous low back pain was about 15%. Average Japanese Orthopaedic Association, Oswestry Disability Index, and Roland-Morris Disability Questionnaire scores at follow-up were 25 points, 7.3%, and 1.6, respectively. The average SRS-22 scores were 4.2 (function), 4.3 (pain), 3.7 (self-image), and 3.9 (mental health) for the postoperative follow-up group compared with 4.5 (function), 4.3 (pain), 3.5 (self-image), and 3.5 (mental health) for the nonscoliosis controls.ConclusionImproved preservation of normal sagittal alignment resulted in a prevalence of low back pain comparable with the age-matched general population. Moreover, SRS-22 results for self-image and mental health were positive compared with the controls, possibly reflecting the surgeon's emphases on mental health and management of patient expectations.Level Of Evidence4.

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