• World Neurosurg · Jul 2020

    Multicenter Study Comparative Study

    Impact of Pregnancy on Loss of Deformity Correction After Pedicle Screw Instrumentation for Adolescent Idiopathic Scoliosis.

    • Pawel Grabala, Ilkka Helenius, Suken A Shah, A Noelle Larson, Jacob M Buchowski, Michal Latalski, Michal Grabala, and Tomasz Guszczyn.
    • Department of Pediatric Orthopaedics and Traumatology, Faculty of Medicine, Medical University of Bialystok, Bialystok, Poland; Department of Neurosurgery, Polish Mothers' Memorial Hospital-Research Institute, Lodz, Poland. Electronic address: pgrabala@wp.pl.
    • World Neurosurg. 2020 Jul 1; 139: e121-e126.

    ObjectiveA retrospective multicenter comparative study was carried out to evaluate whether pregnancy leads to the loss of deformity correction (LOC) in female patients surgically treated for idiopathic scoliosis.MethodsA total of 128 female patients who underwent segmental spinal instrumentation and fusion for adolescent idiopathic scoliosis (AIS) between 1999 and 2014 were reviewed. Of these patients, 62 became pregnant (surgery-pregnancy group [SPG]), whereas 66 did not (surgery-nonpregnancy [SNP] group). Radiographic parameters were analyzed before surgery, after surgery, before pregnancy, up to 1 year after delivery, and at final follow-up (FFU). Health-related quality of life was analyzed using the Scoliosis Research Society outcome questionnaire (SRS-22r).ResultsThe mean age at the time of surgery was 16 years in both groups. The mean preoperative major curves were 65° (standard deviation [SD], 12°) versus 67° (SD, 11°), 18° (SD, 9°) versus 17° (SD, 9°) immediately after surgery, and 20° (SD, 8°) versus 20° (SD, 8°) at FFU in the SPG and SNP groups, respectively (P > 0.10 for all comparisons). The mean loss of correction was 3.5° (SD, 3°) in the SPG and 4.5 (SD, 3°) for SNP groups, respectively (P = 0.379). The mean preoperative thoracic kyphosis (T5-T12) was 26.5° (SD, 11.9°) for SPG and 24.7° (SD, 14.5°) for SNP, after surgery 19.2° (SD, 9.5°) for SPG, 18.8 (SD, 8.9°) for SNP and at FFU, 20.3° (SD, 9°) for SPG and 21.3° (SD, 8.5°) for SNP.ConclusionsWomen who have undergone pedicle screw instrumentation and fusion who have had ≥1 pregnancies do not have curve progression or deterioration in the longer-term outcomes compared with patients who have not become pregnant.Copyright © 2020 Elsevier Inc. All rights reserved.

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