Clinical and radiographic characteristics in male and female adolescent candidates for idiopathic scoliosis surgery

Background: Gender differences in adolescent idiopathic scoliosis (AIS) have been documented in curve progression, response to bracing, and outcomes of surgical treatment. However, limited information is available about the relation between gender and scoliosis curve patterns and radiographic characteristics. Objectives: To evaluate the effect of gender on curve pattern and compare clinical and radiographic characteristics between male and female patients with AIS. Methods: We conducted a retrospective review of prospectively collected data that compared clinical and radiographic characteristics between male and female surgical candidates. Demographic and clinical data including age at presentation, gender, family history of scoliosis, brace treatment history, clinical coronal balance, shoulder asymmetry, and hump size were recorded. All patients graded their pain with the use of a visual analogue scale (VAS) on a scale from 0 to 10. Radiographs of the spine were reviewed to determine the type of curve according to the Lenke classification, Cobb angle, thoracic kyphosis angle, and the Risser sign. Radiologic coronal balance was recorded. Curve flexibility was determined by measuring the thoracic and lumbar curve magnitude on side-bending radiographs. Results: The study included 163 patients with AIS – 35 males and 128 females. Although a trend toward more flexible major thoracic curves in females was noticed, there was no statistically significant difference between the two groups. Conclusions: In this study we were not able to demonstrate any clinical nor radiological statistical differences between male and female candidates for surgical treatment.