INTRODUCTION: A consecutive series of patients with adolescent idiopathic scoliosis (AIS), treated between 1968 and 1977 before 21 years of age, with brace (BT, n=127; 122 females and 5 males) were followed at least twenty years after completion of the treatment.

Methods: One hundred and nine patients were reexamined as part of an unbiased personal follow-up, including a clinical examination, radiographs, validated questionnaires in terms of general and disease-specific quality of life aspects as well as present back and pain symptoms. An age- and sex-matched control group (CTR) of 100 persons was randomly selected and subjected to the same examinations.

Results: Curve size (major curve) was mean 38 degrees with a mean increase of 8 degrees from end of treatment to present follow-up. Significantly more patients complained of back pain (77%) in comparison to the control group (58%, p=0.0012), more often lumbar or thoracic pain. Significant but numerically small differences could be found for Oswestry Disability Index and other scores reflecting general back funtion and more patients had been on sick-leave due to the back (38% vs 19%). No differences were found in sociodemographic variables or in general quality of life (SF-36) between the groups. No correlation could be found between pain and its localization and curve size, increase since end of treatment or curve type.

Conclusion: Patients with brace treatment for adolescent idiopathic scoliosis were found to have approximately the same back function as the general population. A few were physically severely disabled due to the back

Introduction: A consecutive series of patients with adolescent idiopathic scoliosis (AIS), treated between 1968 and 1977 before 21 years of age, with distraction and fusion using Harrington rods (ST, n=156; 145 females and 11 males) were followed at least twenty years after completion of the treatment.

Methods: One hundred and thirty-nine patients were reexamined as part of an unbiased personal follow-up, including a clinical examination, radiographs, validated questionnaires in terms of general and disease-specific quality of life aspects as well as present back and pain symptoms. An age- and sex-matched control group of 100 persons was randomly selected and subjected to the same examinations.

Results: Curve size was mean 36 degrees and nine of the patients (6%) had undergone any additional curve-related surgical procedure due to complications. Significantly more patients complained of back pain (78%) in comparison to the control group (58%, p=0.0012), mainly lumbar but mild pain. Significant but numerically small differences could be found for Oswestry Disability Index but not for sociodemographic variables or general quality of life (SF-36) between the groups. No correlation could be found between pain and its localization and curve size, increase since end of treatment or curve type. No differences were found between patients fused to L3/higher versus L4/lower.

Discussion and conclusion: Patients surgically treated for adolescent idiopathic scoliosis were found to have approximately the same quality of life and back function as the general population and only a few were physically severely disabled.

Introduction: A consecutive series of patients with adolescent idiopathic scoliosis, treated between 1968 and 1977 before 21 years of age, either with distraction and fusion using Harrington rods (ST, n=156; 145 females and 11 males) or with brace (BT, n=127; 122 females and 5 males) were followed at least twenty years after completion of the treatment to determine the long-term outcome in terms of health related quality of life (HRQL) in patients treated for adolescent idiopathic scoliosis. No results on long term outcome of HRQL have previously been presented for this group of patients.

Methods and Results: Ninety-four per cent of ST and 91% of BT patients filled in a questionnaire comprising the SF-36, Psychological General Well-Being Index (PGWB), Oswestry Disability Back Pain Questionnaire, parts of SRS/MODEM’s questionnaire and study-specific questions concerning the treatment, as a part of an unbiased personal follow-up examination. An age and sex-matched control group of 100 persons was randomly selected and subjected to the same examinations. There were no differences in terms of sociodemographic data between the groups. Both ST and BT patients had a slightly, but significantly reduced physical function using the SF-36 subscales, SF-36/Physical Component Summary (PCS) score as well as the Oswestry Disability Back Pain Questionnaire compared to the controls. Neither the mental subscales and the Mental Component Summary (MCS) score of SF-36 nor the PGWB index showed any significant difference between the groups. Forty-nine per cent of ST, 34% of BT and 15% of controls admitted limitation of social activities due to their back, (p< 0.001 ST vs. controls, BT vs. controls p= 0.010, and p=0.024 n.s. ST vs. BT), mostly due to difficulties to physically participate in activities or selfconsciousness about appearance. Pain was a minor reason for limitation. No correlation could be found between the outcome scores and curve size after treatment, curve type, total treatment time or age at completed treatment.

Conclusions: Patients treated for adolescent idiopathic scoliosis were found to have approximately the same HRQL as the general population. A minority of the patients (4%) had a severely decreased psychological well-being and a few (1.5%) were physically severely disabled due to the back.

We reviewed two comparable groups of patients who had been treated for lumbar disc herniation by chymopapain chemonucleolysis (145) or conventional surgical discectomy (91). They were reviewed 10 years after treatment by questionnaire, followed by a personal interview by an independent observer. The results of the surgically treated groups were slightly better than those treated with chymopapain. In particular, there was significantly better early relief of leg and low back pain, and fewer patients needed a second procedure. Complications were few in both groups.