Abstract
BackgroundPatient-reported outcomes are becoming increasingly recognised in the management of patients with adolescent idiopathic scoliosis (AIS). Integrated Shape Imaging System 2 (ISIS2) surface topography is a validated tool to assess AIS. Previous studies have failed to demonstrate strong correlations between AIS and patient-reported outcomes highlighting the need for additional objective surface parameters to define the deformities associated with AIS. The aim of this study was to examine whether the Scoliosis Research Society-22 (SRS-22) outcome questionnaire reflects the degree of measurable external asymmetry of the back in AIS and thus is a measure of patient outcome for external appearance.MethodsA total of 102 pre-operative AIS patients were identified retrospectively. Objective parameters were measured using ISIS2 surface topography. The associations between these parameters and the self-image and mental health domains of the SRS-22 questionnaire were investigated using correlation coefficients.ResultsAll correlations between the parameters of asymmetry and SRS-22 self-image score were of weak strength. Similarly, all correlations between the parameters of asymmetry and SRS-22 mental health score were of weak strength.ConclusionThe SRS-22 mental health and self-image domains correlate poorly with external measures of deformity. This demonstrates that the assessment of mental health and self-image by the SRS-22 has little to do with external torso shape. Whilst the SRS-22 assesses the patient as a whole, it provides little information about objective measures of deformity over which a surgeon has control.
Highlights
Patient-reported outcomes are becoming increasingly recognised in the management of patients with adolescent idiopathic scoliosis (AIS)
All correlations between the parameters of asymmetry and Scoliosis Research Society (SRS)-22 self-image score were of weak strength
Despite the extensive number of parameters of asymmetry used, our study was only able to identify weak correlations with the Scoliosis Research Society-22 (SRS-22) self-image and mental health domains. This demonstrates that the assessment of mental health and self-image by the SRS-22 seems to have little to do with measurable external torso shape
Summary
Patient-reported outcomes are becoming increasingly recognised in the management of patients with adolescent idiopathic scoliosis (AIS). The aim of this study was to examine whether the Scoliosis Research Society-22 (SRS-22) outcome questionnaire reflects the degree of measurable external asymmetry of the back in AIS and is a measure of patient outcome for external appearance. A review by Rushton and Grevitt found that, compared to unaffected peers, patients with AIS had statistically worse pain and poorer self-image [14]. Of these SRS domains, self-image was the only one found to be consistently worse clinically
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