9:43 Discrimination validity of the modified Scoliosis Research Society outcomes instrument in adults with scoliosis

Abstract

Purpose of study: The modified Scoliosis Research Society (MSRS) questionnaire has been proposed as an instrument for measurement of disease-specific health status in patients with scoliosis. The purpose of this study is to report the discrimination validity of the MSRS instrument in differentiating between adults with and without scoliosis and to define the relationship between outcome domains and specific radiographic parameters of spinal deformity.Methods used: Adults with scoliosis and age/gender-matched controls were studied in an observational study. Discrimination validity of the MSRS questionnaire was determined by comparing the means of responses in each domain between adults with scoliosis and a control group without scoliosis. Pearson correlation analysis was used to determine the relationship of each domain of the MSRS and Short Form (SF)-36 questionnaires compared with radiographic process variables, including sagittal balance, coronal balance and major curve magnitude.of findings: A total of 180 adults were included, 146 with scoliosis and 34 without. Average age was 47 years (18 to 86 years), with 165 females and 15 males. Adults with scoliosis scored significantly lower on the MSRS and the SF-36 questionnaires in all domains: Pain (p=.0001), Function (p=.0001), Self-image (p=.0001) and Mental Health (p=.012). Pearson correlation analysis demonstrated no significant correlation between any radiographic process measure and any specific domain within the MSRS and SF-36 instruments (r<0.25).Relationship between findings and existing knowledge: Previous literature has reported that scoliosis may have a limited impact on pain and function in adults. These results suggest that adult deformity has a significant and measurable impact on affected patients compared with controls. There is a poor correlation between radiographic parameters of deformity and outcome domains, including Pain, Function, Self-image, Mental Health and Satisfaction with Surgery. This finding suggests that no one process variable is most predictive of outcome using a self-assessment disease-specific instrument.Overall significance of findings: Adult patients with scoliosis have significant pain and limited function compared with unaffected controls. Process variables including radiographic measures correlate poorly with patient self-assessment of outcome.Disclosures: No disclosures.Conflict of interest: No conflicts.