Influence of socioeconomic deprivation and geographic disparities in the management of surgical adolescent idiopathic scoliosis: a multicentric retrospective cohort in Northern France.

PURPOSE

Few data are available in the literature in Europe on the possible impact of social health inequalities on the therapeutic management of idiopathic scoliosis. This study aimed to determine whether the adolescent's care pathway in the French health system, affected by idiopathic scoliosis, from the stage of diagnosis to the postoperative stage, could be influenced by socio-economic deprivation.

METHODS

This retrospective, multicenter study analyzed 883 patients with surgery for adolescent idiopathic scoliosis between 2009 and 2019. The main clinical outcomes were the Cobb angle at first specialist consultation, brace compliance, the Cobb angle at surgery indication, the time to surgery, postoperative correction, and complications. A multiple linear regression model and multiple logistic regression model were performed to analyze the main outcomes according to the European Deprivation Index (EDI) and Scale Index.

RESULTS

With the exception of Cobb's angle at the first consultation (OR = 1.03 [1.01-1.04]) and on postoperative correction (OR = 0.997 [0.995-0.999]) socio-economic deprivation did not significantly influence the course of care of the adolescent operated on with idiopathic scoliosis.

CONCLUSION

This study suggested the restricted influence of social deprivation on the management of surgical adolescent idiopathic scoliosis in the French health system. It seems that deprivation occurs only before special therapeutic management, strengthening the importance of systematic screening. Further studies are needed to assess the impact of different socioeconomic factors on this pathology.