Self-evaluation of Trunk Aesthetics in Conservatively Treated Children and Adolescents with Idiopathic Scoliosis.

Abstract

Trunk deformity is an important manifestation of idiopathic scoliosis (IS). Patients' perception of spinal deformity and its impact on their quality of life (QoL) are important aspects of scoliosis treatment. The aim of this study was to determine the correlation between radiographic parameters (Cobb angle), clinical parameters (angle of trunk rotation, ATR), and the type of conservative treatment used vs the perception of trunk aesthetics as well as QoL in IS patients. The study enrolled 90 subjects (68 females, 22 males) diagnosed with IS (age: 9-18 years, 14.3± 2.1; Cobb angle 10-66°, 22.2°±12.2; ATR 2-20°, 7.6°±3.9). The study group was divided into (1) patients treated with bracing and physiotherapy (n=35) and (2) subjects undergoing physiotherapy alone (n=55). The perception of trunk deformity was analysed with the TAPS visual scale. QoL was measured with the Polish version of the SRS-22 questionnaire. The study showed that the patients' perception of their trunk aesthetics significantly worsened with increasing Cobb angle (TAPS, rS= -0.327, p<0.01) and ATR (TAPS, rS= -0.228, p<0.05) values. Moreover, higher ATR values sig-ni-ficantly decreased the patients' QoL (SRS-22, rS= -0.232, p<0.05). Bracing significantly worsened the patients' perception of aesthetics and QoL (TAPS, 3.2±0.8 vs 3.8±0.6, p<0.05; SRS-22, 3.9±0.4 vs 4.0±0.4, p<0.05 for patients treated with bracing and physiotherapy alone, respectively). 1. The magnitude of scoliosis, angle of trunk rotation, and bracing leads to worsen perception of trunk aesthetics and quality of life. 2. The curvature angle, angle of trunk rotation, brac-ing, female sex, and age are all associated with a worse perception of trunk aesthetics and quality of life. Self-evaluation of trunk aesthetics and qua-lity of life do not depend on the type of scoliosis. 3. In planning the management of idiopathic sco-lio-sis, one should take into account the impact of spi-nal deformity on worse patient-rated body aes-thetics.