{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:29:28Z","timestamp":1781612968680,"version":"3.54.5"},"reference-count":59,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T00:00:00Z","timestamp":1675382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: This study aimed to evaluate the treatment outcomes of severe idiopathic scoliosis (IS) and hypothesized that surgical treatment would have a superior impact on the health-related quality of life (HRQoL), pulmonary function (PF), back pain, and sexual function. Methods: We retrospectively reviewed 195 consecutive patients with IS classified into severe (SG) and moderate groups (MG) with a minimum follow-up of two years. Results: The mean preoperative curve was 131\u00b0 and 60\u00b0 in the SG and MG, respectively. The mean preoperative flexibility in the bending films averaged between 22% in the SG and 41% in the MG. After definitive surgery, the main curve was corrected to 61\u00b0 and 18\u00b0 in the SG and MG, respectively. The mean preoperative thoracic kyphosis was 83\u00b0 in the SG and 25\u00b0 in the MG, which was corrected to 35\u00b0 in the SG and 25\u00b0 in the MG. At baseline, the percentage of predicted lung volume (FVC) was significantly lower in the SG than that in the MG (51.2% vs. 83%). The baseline percentage of the predicted FEV1 values was also significantly lower in the SG than in the MG (60.8% vs. 77%). During the two-year follow-up, the percentage of predicted FVC showed significant improvement in the SG (69.9%) (p &lt; 0.001), and the percentage of predicted FEV1 values during the follow-up improved significantly in the SG (76.9%) (p &lt; 0.001) compared with the MG (81%), with no statistical difference observed during the two-year follow-up. The SRS-22r showed a clinically and statistically significant improvement in the preoperative results to those of the final follow-up (p &lt; 0.001). Conclusions: Surgical treatment of severe scoliosis can be safe. It provided a mean correction of the deformity for 59% of patients and significantly improved respiratory function, with the percentage of predicted forced expiratory volume in 1 s improving by 60% and the forced vital capacity improving by 50%, resulting in clinically and statistically significant improvements in the SRS-22r, HRQoL outcome scores, and back pain (reduced from 36% to 8%), as well as improved sexual function. The planned surgical treatment can achieve a very significant deformity correction with a minimal risk of complications. The surgical treatment has a superior impact on the quality of life patients with severe spinal deformities and significantly improves function in every sphere of life.<\/jats:p>","DOI":"10.3390\/children10020299","type":"journal-article","created":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T02:57:32Z","timestamp":1675652252000},"page":"299","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["The Efficacy of a Posterior Approach to Surgical Correction for Neglected Idiopathic Scoliosis: A Comparative Analysis According to Health-Related Quality of Life, Pulmonary Function, Back Pain and Sexual Function"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7059-2935","authenticated-orcid":false,"given":"Pawel","family":"Grabala","sequence":"first","affiliation":[{"name":"University Children\u2019s Hospital, Department of Pediatric Orthopedic Surgery and Traumatology, Medical University of Bialystok, Waszyngtona 17, 15-274 Bialystok, Poland"},{"name":"Paley European Institute, Al. Rzeczypospolitej 1, 02-972 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5200-3279","authenticated-orcid":false,"given":"Ilkka J.","family":"Helenius","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Helsinki University Hospital, 00260 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob M.","family":"Buchowski","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Washington University School of Medicine, 660 S Euclid Ave, St. Louis, MO 63110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suken A.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Nemours Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE 19803, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1056\/NEJMcp1209063","article-title":"Clinical practice. 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