230. Impact of poor mental health on clinical outcomes in surgically treated adolescent idiopathic scoliosis patients

Abstract

BACKGROUND CONTEXT Prior literature in patients with adult spine deformity has found that poor mental health at baseline is associated with worse postoperative outcomes. PURPOSE The purpose of this study is to demonstrate that adolescent idiopathic scoliosis (AIS) patients with poor mental health at baseline can experience significant improvements with surgery. We hypothesize that in AIS, low SRS-22r mental health scores are largely due to the presence of deformity. The purpose of this study is determine if the correction of the deformity would potentially improve mental health scores. STUDY DESIGN/SETTING Retrospective review of prospective AIS registry. PATIENT SAMPLE Adolescents with idiopathic scoliosis. OUTCOME MEASURES Mental health scores and percent of patients reaching minimum clinically important difference (MCID) at 2 years postoperative. METHODS A total of 1,532 (1,261 girls, 271 boys) with available baseline and 2-years follow-up SRS-22r scores were included. Patients with baseline mental health domain scores who were 1 standard deviation below the mean ( 4.7) were classified as “high mental health” score (HMH) group. The remaining patients were classified as “intermediate mental health” score (IMH). A minimal clinically important difference (MCID) of 0.6 was used for SRS-22r for analysis RESULTS There were 247 patients in the LMH group, 1,015 in the MMH group, and 270 in the HMH group. Compared to baseline, all 3 groups demonstrated significant improvements in the overall SRS-22r scores at the 2-year follow-up: 0.8 ±0.5 in the LMH group, 0.5 ±0.4 in the IMH group, and 0.29 ±0.35 in the HMH group (P CONCLUSIONS In distinction from adult deformity patients, in the AIS population, alterations in normal body image may results in low mental health at baseline. These patients can experience significant benefit with surgery, and majority of these patients achieve MCID for the SRS-22r at the 2-year follow-up. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.