195. Residual curve and truncal shift impact patient satisfaction after surgery for adolescent idiopathic scoliosis

Abstract

BACKGROUND CONTEXT Prior adolescent idiopathic scoliosis (AIS) literature has demonstrated that patient satisfaction correlated weakly with individual SRS-22r domains and did not correlate with specific radiographic parameters. PURPOSE The purpose of this study is to demonstrate the effect of residual deformity on patient satisfaction. We hypothesize that in patients with AIS, residual deformity maybe associated with worse satisfaction. STUDY DESIGN/SETTING Retrospective analysis of a prospective AIS registry. PATIENT SAMPLE A total of 1,229 Lenke 1 and 2 AIS patients with available radiographic data and SRS scores at the 2-year follow-up were included. OUTCOME MEASURES Patient satisfaction using the SRS-22r satisfaction domain, categorized into 2 groups: Complete satisfaction (5/5) and incomplete satisfaction/dissatisfaction ( METHODS A total of 1,229 Lenke 1 and 2 AIS patients with available radiographic data and SRS scores at the 2-year follow-up were included. A score of 5 on the SRS-22r satisfaction domain at 2 years was considered “complete satisfaction,” and anything below a score of 5 was considered “incomplete satisfaction/dissatisfaction.” Radiographic parameters that were 2 standard deviations below the mean were deemed to have a “residual deformity.” Univariate and binary logistic analyses were performed to assess the association of residual deformity with patient satisfaction. RESULTS At the 2-year follow-up, 689 (60%) patients reported complete satisfaction, while 455 (40%) reported incomplete satisfaction/dissatisfaction. Radiographic factors associated with incomplete satisfaction/dissatisfaction were: residual trunk shift (OR 3.32, p=0.001) and residual major curve (OR 1.7, p=0.036). Patients with residual trunk shift and major curve also had worse SRS-22r self-image domain scores at the 2-year follow-up. Residual differences in shoulder height (p=0.534), T1 tilt angle (p=0.062), Apex to CSVL distance (p=0.969), and percent correction of the major curve (p=0.102) did not reach statistical significance for predicting incomplete satisfaction/dissatisfaction. CONCLUSIONS Residual curve (>34) and truncal shift (>2.2cm) impact patient satisfaction after surgery for AIS. These factors ought to be taken into account during surgical planning. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.