Is there any difference in the perioperative outcome between male and female adolescent idiopathic scoliosis patients undergoing posterior spinal fusion? A propensity score matching analysis study of 570 patients.

Abstract

Purpose: To compare the perioperative outcome differences between male and female AIS patients who underwent posterior spinal fusion (PSF) surgeries.

Methods: This was a retrospective study of 570 patients (84 male, 486 female). Patients were divided into male and female groups. A propensity score matching analysis was performed with match tolerance of 0.005. Preoperative data collected were age, height, weight, body mass index (BMI), Lenke curve classification, preoperative Cobb angle, and preoperative flexibility. Intraoperative data collected were operation duration, intraoperative blood loss, amount of salvaged blood, number of patients required transfusion, number of screws and fusion level. Postoperative data collected were postoperative hemoglobin, postoperative Cobb angle, correction rate, length of postoperative hospital stay and perioperative complications.

Results: Before matching, age, height, weight, and fusion level showed significant difference between genders (p < 0.05). After matching, there was no difference in the perioperative outcome parameters. When matched patients excluding height and weight, males had significantly longer wound, higher intraoperative blood loss and more blood salvaged from cell saver. When matched patients excluding fusion levels, males had significantly higher intraoperative blood loss. When matched patients excluding age, we found no significant differences.

Conclusion: Male AIS patients who underwent PSF surgeries were older, taller, heavier and had longer fusion levels but there was no difference in perioperative outcomes between matched male and female patients.