AIS patients have improved total SRS-22r self-image and satisfaction scores relative to pre-op at 10-year follow-up regardless of Lenke type.

Purpose: Few studies have investigated quality-of-life (QoL)-related outcome measures in adolescent idiopathic scoliosis (AIS) patients over long-term follow-up. We investigated whether patients with any given Lenke type improved relative to other types and whether selective fusions resulted in better QoL-related outcome measures.

Methods: We utilized the Harms Study Group database to select patients with AIS who underwent posterior spinal fusion (PSF) with Scoliosis Research Society questionnaire-22 revised (SRS-22r) scores at minimum 10-year follow-up. Characteristics and SRS-22r were quantified by Lenke type and compared using ANOVA and Tukey post hoc tests. Multivariate analyses were conducted to identify the predictive value of Lenke types on QoL-related outcomes. Sub-group analysis split cohorts into those who underwent selective vs. non-selective fusion(s).

Results: 110 patients were available at minimum 10-year follow-up. Types 3, 4, and 6 curves generally demonstrated lower SRS-22r scores both preoperatively and at long-term follow-up. Independent of Lenke type, total SRS-22r, along with self-image and satisfaction, showed consistent improvement relative to pre-op at 10-year follow-up, whereas pain, mental health, and general function showed a slight worsening. Sub-group analyses revealed no significant differences in SRS-22r scores between selective and non-selective fusion groups.

Conclusions: At 10-year follow-up, total SRS-22r, self-image, and satisfaction scores stayed consistently improved relative to preoperative status over time, while pain, general function, and mental health declined from 2 years onward. Increased age may play a role in enhancing self-image and satisfaction while worsening general function, pain, and mental health. Selectively vs. non-selectively fusing a patient should not hinge on fear of impacting patients' QoL-related measures, as our data suggest improvement in total SRS-22r, self-image, and satisfaction regardless.

Level Of Evidence: III.