Functional Limitations, Body Structure and Function Impairments, and Quality of Life in Adults After Surgical Treatment of Adolescent Idiopathic Scoliosis (AIS)

Functional Limitations, Body Structure and Function Impairments, and Quality of Life in Adults After Surgical Treatment of Adolescent Idiopathic Scoliosis With Comparison to Non-Operatively Treated and Non-Scoliotic Individuals

Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity, and a subset of patients undergo surgical correction during adolescence, most commonly posterior spinal fusion (PSF). Although surgical treatment improves deformity and quality of life in the short and mid-term, its long-term impact on functional status in adulthood remains insufficiently understood.

This cross-sectional study aims to evaluate long-term outcomes in adults aged 25-40 years who underwent surgical treatment for AIS, compared with non-operated individuals with scoliosis and healthy controls. The study will assess limitations in daily functioning, musculoskeletal and respiratory function, pain, and compensatory mechanisms using standardized clinical measurements and questionnaires.

The findings are expected to provide insight into long-term functional consequences of AIS and support the development of targeted physiotherapy and preventive strategies for adults treated for scoliosis during adolescence.

Study Overview

• Status: Not yet recruiting
• Conditions: Adolescence Idiopathic Scoliosis

Detailed Description

Adolescent idiopathic scoliosis (AIS) is a structural spinal deformity associated with long-term alterations in musculoskeletal function, posture, and respiratory mechanics. In progressive cases, surgical correction using posterior spinal fusion (PSF) is performed during adolescence; however, long-term functional outcomes remain insufficiently characterized.

This observational, cross-sectional study compares adults with surgically treated AIS, conservatively treated AIS, and healthy controls. Participants will undergo a standardized assessment protocol including anthropometric measurements, clinical examination, and patient-reported outcomes.

Anthropometric assessment will include body height, sitting height, body mass, arm span, waist and hip circumference, lower limb length and asymmetry, and chest circumference at rest and maximal inspiration, with derived indices of body proportions.

Functional status will be assessed using an author-developed questionnaire based on the International Classification of Functioning, Disability and Health (ICF), capturing perceived limitations in body functions, activities, participation, and environmental factors.

Clinical evaluation will include assessment of spinal curvature and pelvic alignment using inclinometric and scoliometric methods, as well as range of motion (ROM) of the cervical spine, temporomandibular joint, and peripheral joints. Additional orthopedic functional tests will be performed to assess lumbopelvic and lower limb function.

Pain will be evaluated using validated scales and graphical mapping of pain distribution.

Respiratory assessment will include spirometry and flow-volume measurements conducted according to international standards, chest wall mobility assessment, and measurement of respiratory muscle strength (maximal inspiratory and expiratory pressures). In addition, diaphragm structure and function will be evaluated using ultrasound imaging. Measurements will include diaphragm thickness and thickening fraction during respiratory cycles, as well as diaphragmatic excursion during quiet and deep breathing, performed under standardized conditions. This assessment aims to provide an objective evaluation of diaphragmatic mechanics, which may be altered in individuals with thoracic deformity or after surgical stabilization of the spine.

Exploratory analyses will examine associations between clinical variables and functional outcomes. The study aims to provide a comprehensive characterization of long-term functional status and inform targeted rehabilitation strategies.

• Study Type: Observational
• Enrollment (Estimated): 90

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Polish patients

Description

Inclusion Criteria:

• Female, age 25-40
• AIS diagnosed before age 18 (Cobb angle >35°)
• Operated group: PSF, 10-25 years post-surgery
• Informed consent

Exclusion Criteria:

• Surgery other than PSF
• Surgery performed in adulthood

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
ICF-Based Functional Limitations Questionnaire Total Score	Author-developed questionnaire based on the International Classification of Functioning, Disability and Health (ICF), assessing body functions, activities, participation, and environmental factors. Higher total scores indicate greater disability.	Baseline assessment, single study visit

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Intensity by Visual Analog Scale (VAS)	Pain severity assessed on a 0 to 10 scale. Higher scores indicate greater pain intensity.	Baseline assessment, single study visit
Forced Vital Capacity (FVC % Predicted)	Pulmonary function assessed by spirometry. Higher values indicate better respiratory function.	Baseline assessment, single study visit
Forced Expiratory Volume in 1 Second (FEV1 % Predicted)	Spirometry measure of expiratory volume in one second. Higher values indicate better pulmonary function.	Baseline assessment, single study visit
Angle of Trunk Rotation	Measured using Bunnell scoliometer, reported in degrees.	Baseline assessment, single study visit
Thoracic Kyphosis Angle	Measured using inclinometer/plurimeter, reported in degrees.	Baseline assessment, single study visit
Lumbar Lordosis Angle	Measured using inclinometer/plurimeter, reported in degrees.	Baseline assessment, single study visit
SRS-22 Total Score	Quality of life assessed using the Scoliosis Research Society-22 questionnaire. The questionnaire contains 22 items across five domains (function/activity, pain, self-image/appearance, mental health, and satisfaction with management), each scored from 1 to 5. Mean domain scores and the total mean score range from 1 to 5, with higher scores indicating better function and higher quality of life.	Baseline assessment, single study visit

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Chest Expansion	Difference between maximal inhalation and exhalation chest circumference, reported in centimeters.	Baseline assessment, single study visit
Cervical Rotation Range of Motion	Passive cervical rotation measured in degrees.	Baseline assessment, single study visit
Peripheral Joint Range of Motion	Shoulder, hip, knee, and ankle range of motion measured in degrees.	Baseline assessment, single study visit
Limb Length Discrepancy	Difference between lower limb lengths, reported in centimeters.	Baseline assessment, single study visit
Waist-to-Height Ratio (WHtR)	Calculated from waist circumference and height.	Baseline assessment, single study visit
Maximum Mouth Opening	Mandibular abduction measured in centimeters.	Baseline assessment, single study visit

Collaborators and Investigators

• Sponsor: Józef Piłsudski University of Physical Education

Study record dates

Study Major Dates

• Study Start (Estimated): May 16, 2026
• Primary Completion (Estimated): August 16, 2028
• Study Completion (Estimated): August 16, 2028

Study Registration Dates

• First Submitted: March 27, 2026
• First Submitted That Met QC Criteria: April 24, 2026
• First Posted (Actual): April 30, 2026

Study Record Updates

• Last Update Posted (Actual): May 18, 2026
• Last Update Submitted That Met QC Criteria: May 14, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: spinal fusion; Adolescent Idiopathic Scoliosis; adult scoliosis; Long-Term Adverse Effects
• Additional Relevant MeSH Terms: Bone Diseases; Musculoskeletal Diseases; Pathologic Processes; Spinal Diseases; Spinal Curvatures; Pathological Conditions, Signs and Symptoms; Long Term Adverse Effects; Scoliosis
• Other Study ID Numbers: SKE.0030.4.2026

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No