Patient self-reported outcomes 10 years after surgical correction in AIS patients. A systematic review and meta-analysis.

INTRODUCTION

the aim of this report is to evaluate the long-term (≥ 10 years) functional outcomes and quality of life after surgery in AIS patients.

METHODS

PROSPERO (CRD42023439331). Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Systematic Review (PRISMA) guidelines were followed. The PubMed, EMBASE, Scopus, and Cochrane Collaboration Library databases were used. Comparative studies assessing outcomes ≥ 10 years after surgery in AIS patients and controls were included. Study quality was assessed using the MINORS criteria. The outcomes of interest were SRS-22/24 scores for pain, self-image, function, mental health, total score, and the Oswestry Disability Index (ODI). Comparisons were performed using mean difference (MD) with 95% confidence interval (CI). Heterogeneity was assessed using the I2 statistic. A fixed effects model was used if there was no evidence of heterogeneity.

RESULTS

Four comparative cohort studies and four case series were analyzed (n = 586). At long-term follow-up, pain (MD -0.47, 95%CI -0.64 to -0.30), self-image (MD -0.45, 95%CI -0.62 to -0.28), function (MD -0.45, 95%CI -0.83 to -0.07), and mental health (MD -0.53,95%CI -0.84 to -0.23) SRS-22 domains were significantly lower in surgically treated AIS patients than in controls. The total SRS score (MD -0.38, 95%CI -0.58 to -0.17) and ODI scores (MD 3.12, 95%CI 0.51 to 5.73) were lower in surgically treated patients. No significant differences were noted pre- and postoperatively ≥ 10 years after surgery in pain (MD -0.05,95%CI -0.32 to 0.23) and function (MD -0.05,95%CI -0.30 to 0.21), while self-image (MD -0.68,95%CI -1.02 to -0.34) and mental health (MD -0.37,95%CI -0.99 to 0.25) improved.

CONCLUSION

Ten years or more after surgery, patients with AIS had a significantly lower quality of life and higher disability than their healthy peers, based on lower SRS scores in multiple domains and higher ODI, except for self-image and mental health that improved.