{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T22:04:31Z","timestamp":1789164271946,"version":"build-2803163510"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Adolescent idiopathic scoliosis (AIS), the most common type of scoliosis, often presents immediately prior to a woman\u2019s childbearing years; however, research investigating the impact of AIS on women\u2019s health, particularly pregnancy delivery outcomes, is sparse, with existing literature reporting mixed findings. Similarly limited are studies examining the change in scoliotic curve during or after pregnancy. Therefore, this study aims to determine 1) the impact of scoliotic curvature on obstetric complications (preterm births, induction of labor, and urgent\/emergency caesarean section delivery), 2) regional anesthetic decision making and success during delivery for these patients, and 3) the effect of pregnancy on curve progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Records of all pregnant patients diagnosed with AIS at the authors\u2019 institution who delivered between January 2002 and September 2016 were retrospectively reviewed. Demographic information, pre- and postpartum radiographic Cobb angles, and clinical data for each pregnancy and delivery were recorded and analyzed. The Wilcoxon rank-sum test and the Wilcoxon signed-rank test were used for statistical analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Fifty-nine patients (84 deliveries) were included; 14 patients had undergone prior posterior spinal fusion. The median age at AIS diagnosis was 15.2 years, and the median age at delivery was 21.8 years. Overall, the median major Cobb angle prior to the first pregnancy was 25\u00b0 (IQR 15\u00b0\u201340\u00b0). Most births were by spontaneous vaginal delivery (n = 45; 54%); elective caesarean section was performed in 17 deliveries (20%). Obstetric complications included preterm birth (n = 18; 21.4%), induction of labor (n = 20; 23.8%), and urgent\/emergency caesarean section (n = 12; 14.0%); none were associated with severity of scoliosis curve or prior spinal fusion. Attempts at spinal anesthesia were successful 99% of the time (70\/71 deliveries), even among the patients who had undergone prior spinal fusion (n = 13). There were only 3 instances of provider refusal to administer spinal anesthesia. In the subset of 11 patients who underwent postpartum scoliosis radiography, there was no statistically significant change in curve magnitude either during or immediately after pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The results of this study suggest that there was no effect of the severity of scoliosis on delivery complications or regional anesthetic decision making in pregnant patients with AIS. Moreover, scoliosis was not observed to progress significantly during or immediately after pregnancy. Larger prospective studies are needed to further investigate these outcomes, the findings of which can guide the prenatal education and counseling of pregnant patients with AIS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2017.7.focus17321","type":"journal-article","created":{"date-parts":[[2017,10,1]],"date-time":"2017-10-01T03:37:29Z","timestamp":1506829049000},"page":"E4","source":"Crossref","is-referenced-by-count":18,"title":["The impact of curve severity on obstetric complications and regional anesthesia utilization in pregnant patients with adolescent idiopathic scoliosis: a preliminary analysis"],"prefix":"10.3171","volume":"43","author":[{"given":"Emily W.","family":"Chan","sequence":"first","affiliation":[{"name":"Surgical Outcomes Center for Kids, and"},{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen R.","family":"Gannon","sequence":"additional","affiliation":[{"name":"Surgical Outcomes Center for Kids, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chevis N.","family":"Shannon","sequence":"additional","affiliation":[{"name":"Surgical Outcomes Center for Kids, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey E.","family":"Martus","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery and Rehabilitation and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory A.","family":"Mencio","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery and Rehabilitation and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M.","family":"Bonfield","sequence":"additional","affiliation":[{"name":"Surgical Outcomes Center for Kids, and"},{"name":"Neurological Surgery, Monroe Carell Jr. Children\u2019s Hospital at Vanderbilt, Nashville; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Anesth Analg","first-page":"981","article-title":"Labor analgesia consumption and time to neuraxial catheter placement in women with a history of surgical correction for scoliosis: a case-matched study","volume":"121","author":"Bauchat JR","year":"2015","unstructured":"Bauchat JR, McCarthy RJ, Koski TR, Wong CA: Labor analgesia consumption and time to neuraxial catheter placement in women with a history of surgical correction for scoliosis: a case-matched study. Anesth Analg 121:981\u2013987, 2015"},{"key":"b2","series-title":"J Bone Joint Surg Am","first-page":"90","article-title":"Scoliosis and pregnancy","volume":"69","author":"Betz RR","year":"1987","unstructured":"Betz RR, Bunnell WP, Lambrecht-Mulier E, MacEwen GD: Scoliosis and pregnancy. J Bone Joint Surg Am 69:90\u201396, 1987"},{"key":"b3","series-title":"J Bone Joint Surg Am","first-page":"1083","article-title":"The effect of pregnancy on idiopathic scoliosis","volume":"62","author":"Blount WP","year":"1980","unstructured":"Blount WP, Mellencamp D: The effect of pregnancy on idiopathic scoliosis. J Bone Joint Surg Am 62:1083\u20131087, 1980"},{"key":"b4","series-title":"J Bone Joint Surg Am","first-page":"328","article-title":"Measurement of scoliosis and kyphosis radiographs. Intraobserver and interobserver variation","volume":"72","author":"Carman DL","year":"1990","unstructured":"Carman DL, Browne RH, Birch JG: Measurement of scoliosis and kyphosis radiographs. Intraobserver and interobserver variation. J Bone Joint Surg Am 72:328\u2013333, 1990"},{"key":"b5","series-title":"Spine (Phila Pa 1976)","first-page":"576","article-title":"Long-term anatomic and functional changes in patients with adolescent idiopathic scoliosis treated by Harrington rod fusion","volume":"8","author":"Cochran T","year":"1983","unstructured":"Cochran T, Irstam L, Nachemson A: Long-term anatomic and functional changes in patients with adolescent idiopathic scoliosis treated by Harrington rod fusion. Spine (Phila Pa 1976) 8:576\u2013584, 1983"},{"key":"b6","series-title":"Can J Anaesth","first-page":"693","article-title":"Obstetric epidural anaesthesia in patients with Harrington instrumentation","volume":"36","author":"Crosby ET","year":"1989","unstructured":"Crosby ET, Halpern SH: Obstetric epidural anaesthesia in patients with Harrington instrumentation. Can J Anaesth 36:693\u2013696, 1989"},{"key":"b7","series-title":"Spine (Phila Pa 1976)","first-page":"1449","article-title":"Childbearing, curve progression, and sexual function in women 22 years after treatment for adolescent idiopathic scoliosis: a case-control study","volume":"26","author":"Danielsson AJ","year":"2001","unstructured":"Danielsson AJ, Nachemson AL: Childbearing, curve progression, and sexual function in women 22 years after treatment for adolescent idiopathic scoliosis: a case-control study. Spine (Phila Pa 1976) 26:1449\u20131456, 2001"},{"key":"b8","series-title":"Global Spine J","first-page":"179","article-title":"Adolescent idiopathic scoliosis and pregnancy: an unsolved paradigm","volume":"5","author":"Falick-Michaeli T","year":"2015","unstructured":"Falick-Michaeli T, Schroeder JE, Barzilay Y, Luria M, Itzchayek E, Kaplan L: Adolescent idiopathic scoliosis and pregnancy: an unsolved paradigm. Global Spine J 5:179\u2013184, 2015 (Erratum in Global Spine J 6:626, 2016)"},{"key":"b9","series-title":"Nat Vital Stat Rep","first-page":"1","article-title":"Births: final data for 2014","volume":"64","author":"Hamilton BE","year":"2015","unstructured":"Hamilton BE, Martin HA, Osterman MJK, Curtin SC, Mathews TJ: Births: final data for 2014. Nat Vital Stat Rep 64:1\u201364, 2015"},{"key":"b10","series-title":"Radiographics","first-page":"1823","article-title":"Scoliosis imaging: what radiologists should know","volume":"30","author":"Kim H","year":"2010","unstructured":"Kim H, Kim HS, Moon ES, Yoon CS, Chung TS, Song HT, : Scoliosis imaging: what radiologists should know. Radiographics 30:1823\u20131842, 2010"},{"key":"b11","series-title":"J Child Orthop","first-page":"3","article-title":"Epidemiology of adolescent idiopathic scoliosis","volume":"7","author":"Konieczny MR","year":"2013","unstructured":"Konieczny MR, Senyurt H, Krauspe R: Epidemiology of adolescent idiopathic scoliosis. J Child Orthop 7:3\u20139, 2013"},{"key":"b12","series-title":"J Matern Fetal Neonatal Med","first-page":"639","article-title":"Mode of delivery and other pregnancy outcomes of patients with documented scoliosis","volume":"25","author":"Lebel DE","year":"2012","unstructured":"Lebel DE, Sergienko R, Wiznitzer A, Velan GJ, Sheiner E: Mode of delivery and other pregnancy outcomes of patients with documented scoliosis. J Matern Fetal Neonatal Med 25:639\u2013641, 2012"},{"key":"b13","series-title":"Spine (Phila Pa 1976)","first-page":"2548","article-title":"The assessment of intraobserver and interobserver error in the measurement of noncongenital scoliosis in children < or = 10 years of age","volume":"29","author":"Loder RT","year":"2004","unstructured":"Loder RT, Spiegel D, Gutknecht S, Kleist K, Ly T, Mehbod A: The assessment of intraobserver and interobserver error in the measurement of noncongenital scoliosis in children < or = 10 years of age. Spine (Phila Pa 1976) 29:2548\u20132553, 2004"},{"key":"b14","series-title":"J Bone Joint Surg Am","first-page":"320","article-title":"Measurement of the Cobb angle on radiographs of patients who have scoliosis. Evaluation of intrinsic error","volume":"72","author":"Morrissy RT","year":"1990","unstructured":"Morrissy RT, Goldsmith GS, Hall EC, Kehl D, Cowie GH: Measurement of the Cobb angle on radiographs of patients who have scoliosis. Evaluation of intrinsic error. J Bone Joint Surg Am 72:320\u2013327, 1990"},{"key":"b15","series-title":"Eur Spine J","first-page":"304","article-title":"Pregnancy and delivery in patients operated by the Harrington method for idiopathic scoliosis","volume":"6","author":"Orvomaa E","year":"1997","unstructured":"Orvomaa E, Hiilesmaa V, Poussa M, Snellman O, Tallroth K: Pregnancy and delivery in patients operated by the Harrington method for idiopathic scoliosis. Eur Spine J 6:304\u2013307, 1997"},{"key":"b16","series-title":"NCHS Data Brief","first-page":"1","article-title":"Recent declines in induction of labor by gestational age","volume":"155","author":"Osterman MJK","year":"2014","unstructured":"Osterman MJK, Martin JA: Recent declines in induction of labor by gestational age. NCHS Data Brief 155:1\u20138, 2014"},{"key":"b17","series-title":"Natl Vital Stat Rep","first-page":"1","article-title":"Trends in low-risk cesarean delivery in the United States, 1990\u20132013","volume":"63","author":"Osterman MJK","year":"2014","unstructured":"Osterman MJK, Martin JA: Trends in low-risk cesarean delivery in the United States, 1990\u20132013. Natl Vital Stat Rep 63:1\u201316, 2014"},{"key":"b18","series-title":"Int J Obstet Anesth","first-page":"17","article-title":"Regional blockade for delivery in women with scoliosis or previous spinal surgery","volume":"12","author":"Smith PS","year":"2003","unstructured":"Smith PS, Wilson RC, Robinson AP, Lyons GR: Regional blockade for delivery in women with scoliosis or previous spinal surgery. Int J Obstet Anesth 12:17\u201322, 2003"},{"key":"b1","series-title":"Anesth Analg","first-page":"981","article-title":"Labor analgesia consumption and time to neuraxial catheter placement in women with a history of surgical correction for scoliosis: a case-matched study","volume":"121","author":"Bauchat JR","year":"2015","unstructured":"Bauchat JR, McCarthy RJ, Koski TR, Wong CA: Labor analgesia consumption and time to neuraxial catheter placement in women with a history of surgical correction for scoliosis: a case-matched study. Anesth Analg 121:981\u2013987, 2015"},{"key":"b2","series-title":"J Bone Joint Surg Am","first-page":"90","article-title":"Scoliosis and pregnancy","volume":"69","author":"Betz RR","year":"1987","unstructured":"Betz RR, Bunnell WP, Lambrecht-Mulier E, MacEwen GD: Scoliosis and pregnancy. 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J Bone Joint Surg Am 72:328\u2013333, 1990"},{"key":"b5","series-title":"Spine (Phila Pa 1976)","first-page":"576","article-title":"Long-term anatomic and functional changes in patients with adolescent idiopathic scoliosis treated by Harrington rod fusion","volume":"8","author":"Cochran T","year":"1983","unstructured":"Cochran T, Irstam L, Nachemson A: Long-term anatomic and functional changes in patients with adolescent idiopathic scoliosis treated by Harrington rod fusion. Spine (Phila Pa 1976) 8:576\u2013584, 1983"},{"key":"b6","series-title":"Can J Anaesth","first-page":"693","article-title":"Obstetric epidural anaesthesia in patients with Harrington instrumentation","volume":"36","author":"Crosby ET","year":"1989","unstructured":"Crosby ET, Halpern SH: Obstetric epidural anaesthesia in patients with Harrington instrumentation. Can J Anaesth 36:693\u2013696, 1989"},{"key":"b7","series-title":"Spine (Phila Pa 1976)","first-page":"1449","article-title":"Childbearing, curve progression, and sexual function in women 22 years after treatment for adolescent idiopathic scoliosis: a case-control study","volume":"26","author":"Danielsson AJ","year":"2001","unstructured":"Danielsson AJ, Nachemson AL: Childbearing, curve progression, and sexual function in women 22 years after treatment for adolescent idiopathic scoliosis: a case-control study. Spine (Phila Pa 1976) 26:1449\u20131456, 2001"},{"key":"b8","series-title":"Global Spine J","first-page":"179","article-title":"Adolescent idiopathic scoliosis and pregnancy: an unsolved paradigm","volume":"5","author":"Falick-Michaeli T","year":"2015","unstructured":"Falick-Michaeli T, Schroeder JE, Barzilay Y, Luria M, Itzchayek E, Kaplan L: Adolescent idiopathic scoliosis and pregnancy: an unsolved paradigm. Global Spine J 5:179\u2013184, 2015 (Erratum in Global Spine J 6:626, 2016)"},{"key":"b9","series-title":"Nat Vital Stat Rep","first-page":"1","article-title":"Births: final data for 2014","volume":"64","author":"Hamilton BE","year":"2015","unstructured":"Hamilton BE, Martin HA, Osterman MJK, Curtin SC, Mathews TJ: Births: final data for 2014. Nat Vital Stat Rep 64:1\u201364, 2015"},{"key":"b10","series-title":"Radiographics","first-page":"1823","article-title":"Scoliosis imaging: what radiologists should know","volume":"30","author":"Kim H","year":"2010","unstructured":"Kim H, Kim HS, Moon ES, Yoon CS, Chung TS, Song HT, : Scoliosis imaging: what radiologists should know. Radiographics 30:1823\u20131842, 2010"},{"key":"b11","series-title":"J Child Orthop","first-page":"3","article-title":"Epidemiology of adolescent idiopathic scoliosis","volume":"7","author":"Konieczny MR","year":"2013","unstructured":"Konieczny MR, Senyurt H, Krauspe R: Epidemiology of adolescent idiopathic scoliosis. J Child Orthop 7:3\u20139, 2013"},{"key":"b12","series-title":"J Matern Fetal Neonatal Med","first-page":"639","article-title":"Mode of delivery and other pregnancy outcomes of patients with documented scoliosis","volume":"25","author":"Lebel DE","year":"2012","unstructured":"Lebel DE, Sergienko R, Wiznitzer A, Velan GJ, Sheiner E: Mode of delivery and other pregnancy outcomes of patients with documented scoliosis. J Matern Fetal Neonatal Med 25:639\u2013641, 2012"},{"key":"b13","series-title":"Spine (Phila Pa 1976)","first-page":"2548","article-title":"The assessment of intraobserver and interobserver error in the measurement of noncongenital scoliosis in children < or = 10 years of age","volume":"29","author":"Loder RT","year":"2004","unstructured":"Loder RT, Spiegel D, Gutknecht S, Kleist K, Ly T, Mehbod A: The assessment of intraobserver and interobserver error in the measurement of noncongenital scoliosis in children < or = 10 years of age. Spine (Phila Pa 1976) 29:2548\u20132553, 2004"},{"key":"b14","series-title":"J Bone Joint Surg Am","first-page":"320","article-title":"Measurement of the Cobb angle on radiographs of patients who have scoliosis. Evaluation of intrinsic error","volume":"72","author":"Morrissy RT","year":"1990","unstructured":"Morrissy RT, Goldsmith GS, Hall EC, Kehl D, Cowie GH: Measurement of the Cobb angle on radiographs of patients who have scoliosis. Evaluation of intrinsic error. J Bone Joint Surg Am 72:320\u2013327, 1990"},{"key":"b15","series-title":"Eur Spine J","first-page":"304","article-title":"Pregnancy and delivery in patients operated by the Harrington method for idiopathic scoliosis","volume":"6","author":"Orvomaa E","year":"1997","unstructured":"Orvomaa E, Hiilesmaa V, Poussa M, Snellman O, Tallroth K: Pregnancy and delivery in patients operated by the Harrington method for idiopathic scoliosis. Eur Spine J 6:304\u2013307, 1997"},{"key":"b16","series-title":"NCHS Data Brief","first-page":"1","article-title":"Recent declines in induction of labor by gestational age","volume":"155","author":"Osterman MJK","year":"2014","unstructured":"Osterman MJK, Martin JA: Recent declines in induction of labor by gestational age. 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