Patient Satisfaction After Surgical Correction of Adolescent Idiopathic Scoliosis

Study Design. Longitudinal cohort. Objective. The purpose of this study is to evaluate the relationship between change in SRS-22 domain scores and satisfaction with management in patients who underwent surgical correction for adolescent idiopathic scoliosis (AIS). Summary of Background Data. The Scoliosis Research Society-22 (SRS-22) is a widely used instrument to measure clinical outcomes in patients with scoliosis. The relationship between patient satisfaction and changes in domain scores in the SRS-22 has not been previously reported. Methods. This is a longitudinal cohort of 745 patients with AIS who underwent surgical correction and had completed SRS-22 preoperative and 2 years postoperative. Patients who had a previous spine surgery were excluded. Wilcoxon tests were used to compare preop and 2-year postop scores. Spearman correlations were used to evaluate associations between change in SRS-22 domain scores from preoperative to 2 years postoperative and the 2-year SRS Satisfaction score. Results. There were 622 females and 123 males with a mean age of 14.2 years and a mean Cobb angle of 54 degrees. There was a statistically significant difference between paired preoperative and 2-year postoperative SRS domain scores. Spearman correlations between the change in SRS domain scores and the SRS Satisfaction score at 2 years postoperative were statistically significant but were low to moderate: Appearance = 0.284, Activity = 0.172, Pain = 0.260, Mental = 0.202, and Total = 0.398. Conclusion. Although there is a statistically significant change in all the SRS domain scores from preoperative to 2 years postsurgical correction of AIS, there was low to moderate associations between the change in any of the domain scores and patient satisfaction with treatment. This may be attributable to the prominent ceiling effect in the Satisfaction domain, or the lack of responsiveness of the SRS-22 to measure clinically relevant changes in activity, pain and mental health 2 years after correction of scoliosis in the adolescent population.