Evaluation of Quality of Life in Adolescent Idiopathic Scoliosis With Different Distal Fusion Level: A Comparison of L3 Versus L4

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Study Design:

Retrospective case-control study.


The aim of this study was to assess patients’ quality of life with different fusion levels in posterior pedicle screw correction of idiopathic scoliosis.

Summary of Background Data:

No previous study has demonstrated differences in health-related quality of life (HRQoL) between patients fused to L3 versus L4.

Materials and Methods:

A retrospective study was conducted on 30 scoliotic patients fused to L3 using complete pedicle screw instruments. Thirty age-matched and sex-matched scoliotic patients fused to L4 were in the control group. Radiologic parameters were assessed before surgery and at latest follow-up between the 2 groups. These 2 groups were compared for the Scoliosis Research Society 22 questionnaire (SRS-22), Oswestry Disability Index (ODI), visual analogue scale (VAS), and Short Form-36 (SF-36) questionnaires, which were administered preoperatively and at final follow-up.


There were no significant differences in sex, age, follow-up duration, the distribution of curve patterns, the postoperative residual Cobb angle of the main curve, complications, or surgical method between the L3 and L4 groups (P>0.05). Preoperative scores were statistically similar in the L3 and L4 groups for all domains of all questionnaires. There was no difference between the L3 and L4 groups for ODI (P=0.527) and VAS (P=0.518). There were no significant differences in the scores on function/activity, self-image/appearance, pain, mental health, or satisfaction with treatment domains between the 2 groups. No significant differences between the 2 groups were found at the final follow-up in the SF-36 subscales/domain scores.


This study attempted to elucidate the correlation between the length of fusion and functional outcome; however, it could not identify any difference between different fusion levels. On the basis of short-term results, there were no significant differences in the questionnaire scores between the 2 groups.

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