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Purpose <p>Adolescent idiopathic scoliosis (AIS) affects physical and psychosocial health, with treatments including surgery, bracing, and observation. However, the long-term effects on health-related quality of life (HRQoL) are still uncertain. The aim of the present study was to evaluate the long-term HRQoL outcomes in untreated AIS patients compared to those undergoing surgical or brace interventions through systematic review and meta-analysis.</p> Methods <p>A systematic search was conducted across multiple databases (PubMed, Scopus, WoS, and Medline). Study quality was assessed using the Methodological Index for Non-randomized Studies (MINORS) tool, and evidence certainty was evaluated using the GRADE system. The primary outcomes of the meta-analysis were measured using SRS-22r and SF-12 scales for the assessment of HRQoL, evaluating domains including function, mental health, pain, self-image, and satisfaction after a minimum ten-year follow-up period.</p> Results <p>Eight studies published between 2010 and 2023 that assessed HRQoL after a follow-up period of ten years or more were included in the systematic review. Six studies were included in the meta-analysis. The observation group showed better outcomes in functional (MD 0.43, 95% CI 0.01–0.84) and mental health domains (MD 0.12, 95% CI 0.03–0.20) compared to the surgical group. No significant differences were found in pain, self-image, and satisfaction domains. Comparison between observation and brace groups showed equivalence across all domains. Evidence certainty ranged from moderate to low.</p> Conclusion <p>Long-term HRQoL in AIS shows no clear benefit of surgery or bracing over observation, which may offer equal or better mental and functional outcomes. This supports personalized care. Further high-quality research is needed to strengthen the evidence base.</p>

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Comparative long-term quality of life outcomes in adolescent idiopathic scoliosis: a meta-analysis of surgical, conservative, and observation-based strategies

  • 期刊论文

  • 发表日期：

    2026年3月12日

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  • Jesús Burgos,
  • Eduardo Hevia,
  • Vicente García,
  • María Teresa de Santos Moreno,
  • María benlloch,
  • Reem Sayad,
  • Gonzalo Mariscal,
  • Carlos Barrios

摘要

Purpose

Adolescent idiopathic scoliosis (AIS) affects physical and psychosocial health, with treatments including surgery, bracing, and observation. However, the long-term effects on health-related quality of life (HRQoL) are still uncertain. The aim of the present study was to evaluate the long-term HRQoL outcomes in untreated AIS patients compared to those undergoing surgical or brace interventions through systematic review and meta-analysis.

Methods

A systematic search was conducted across multiple databases (PubMed, Scopus, WoS, and Medline). Study quality was assessed using the Methodological Index for Non-randomized Studies (MINORS) tool, and evidence certainty was evaluated using the GRADE system. The primary outcomes of the meta-analysis were measured using SRS-22r and SF-12 scales for the assessment of HRQoL, evaluating domains including function, mental health, pain, self-image, and satisfaction after a minimum ten-year follow-up period.

Results

Eight studies published between 2010 and 2023 that assessed HRQoL after a follow-up period of ten years or more were included in the systematic review. Six studies were included in the meta-analysis. The observation group showed better outcomes in functional (MD 0.43, 95% CI 0.01–0.84) and mental health domains (MD 0.12, 95% CI 0.03–0.20) compared to the surgical group. No significant differences were found in pain, self-image, and satisfaction domains. Comparison between observation and brace groups showed equivalence across all domains. Evidence certainty ranged from moderate to low.

Conclusion

Long-term HRQoL in AIS shows no clear benefit of surgery or bracing over observation, which may offer equal or better mental and functional outcomes. This supports personalized care. Further high-quality research is needed to strengthen the evidence base.