Background: Adolescent idiopathic scoliosis (AIS) develops between the ages of 10 and skeletal maturity and can lead to physical, psychosocial, and medical complications if untreated. Posterior spinal fusion (PSF) is the primary surgical intervention when bracing fails. Although sociodemographic factors affect access to care, surgical candidacy, perioperative risk, and recovery, these variables are rarely reported in randomized controlled trials (RCTs), limiting assessment of equity and generalizability in AIS outcomes. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, Embase, and Scopus were searched on 9 April 2024, using “posterior spinal fusion,” “randomized controlled trial,” and “adolescent idiopathic scoliosis.” Inclusion criteria were full-text RCTs on PSF in AIS; exclusions were non-English publications, cadaver studies, and technique articles. Two authors independently screened studies, with disagreements resolved by a third. Extracted variables included demographics and social factors. Analyses used descriptive statistics, chi-squared tests, and Fisher’s exact test ( p < 0.05). Results: Of 148 studies, 44 met the inclusion criteria. Age (97.7%) and sex (95.5%) were reported more frequently than race (6.8%) or ethnicity (9.1%) ( p < 0.001). No studies reported household income, insurance status, housing, employment, or education. Reporting did not differ by journal (Fisher’s exact test, p = 0.999) or publication year (chi-squared test, p = 0.185), although reporting increased slightly after 2017. Conclusions: RCTs on PSF for AIS rarely report sociodemographic variables beyond age and sex. This gap limits understanding of whether outcomes are consistent across populations or if disparities exist in treatment response or recovery. Improved sociodemographic reporting is essential for transparency, external validity, and equity in AIS care. Level of Evidence: Systematic review of Level II.
Brown et al. (Thu,) studied this question.