Hanging radiograph in idiopathic scoliosis patients: significance as a preoperative stress X-ray

Correlation between Scoliosis Flexibility Degree on Preoperative Imaging with Postoperative Curve Correction and Mechanical Complications

(1) Background: In the preoperative planning stage of scoliosis surgery, it is routine to use radiographs obtained with and without traction to observe the curve flexibility in order to estimate curve correction, but its association with mechanical complications is not completely understood. (2) Methods: Retrospective cohort study of all patients undergoing infantile, congenital, neuromuscular or idiopathic adolescent scoliosis correction surgery at a single institution between 2015 and 2019, with a minimum follow-up of 24 months. Associations between qualitative variables were tested with the chi-square test. The association between qualitative and quantitative variables were tested with the Mann–Whitney test, and correlations between quantitative variables was tested with Spearman’s correlation. (3) Results: A total of 330 patients, 88 males and 242 females, with a mean age of 16.98 years at surgery, were included. The mean value of preoperative main curves, its flexibility and postoperative value were 54.44 degrees, 21.73 degrees and 18.08 degrees, respectively. (4) Conclusions: Preoperative spinal X-ray examination with traction or bending films is a reasonable option for assessing scoliotic curve flexibility, and patients with neuromuscular scoliosis who are not ambulatory can be informed of the increased risks of late mechanical complications.