Changes in life satisfaction and self-esteem in patients with adolescent idiopathic scoliosis with and without surgical intervention

Abstract

Study design: Pre-/poststudy comparing surgical and nonsurgical treatment.

Objective: To identify whether orthopedic spinal surgery can effectively improve life satisfaction and self-esteem in patients with adolescent idiopathic scoliosis.

Summary of background data: There have been many studies about the effect of spinal deformity and its various treatments on the mental health of patients with adolescent idiopathic scoliosis. Scoliosis has been reported to have a negative effect on the life quality and mental health of patients. It has also been reported that no matter what the treatment, the existence of scoliosis is a risk factor for depression. However, there has been no report on whether orthopedic spinal surgery affects the life satisfaction and self-esteem of scoliosis patients.

Methods: Forty-six patients with Cobb angles of more than 30° were recruited from a group of patients that were treated from January 2007 to August 2007. Twenty-one patients with Cobb angles of more than 40° underwent surgical correction while the remaining patients received regular observation (n = 11) or bracing (n = 14). Self-esteem and life satisfaction were assessed before and approximately 1 year after treatment using previously validated scales.

Results: There were no between-group differences in age, sex, or major curve location between the surgically and nonsurgically treated groups. The major curve Cobb angle decreased significantly following treatment in the surgically treated (52° ± 10° to 15° ± 8°, P < 0.001), but not the nonsurgically treated group (37° ± 9° to 39° ± 8°, P = 0.4419) using paired t tests. There were no preintervention between-group differences in life satisfaction (8 ± 1 vs. 7 ± 10); however, preintervention self-esteem scores were significantly higher in the nonsurgically treated group (28 ± 4 vs. 25 ± 3, P = 0.008). Postintervention, both life satisfaction (9 ± 1) and self-esteem (31 ± 2) scores improved significantly (P < 0.05) in the surgically treated, but not the nonsurgically treated group (7 ± 1 and 24 ± 5, respectively). Self-esteem levels decreased significantly in the nonsurgically treated group (P < 0.05) Postintervention self-esteem and life satisfaction scores were significantly higher in the surgically treated than the nonsurgically treated group (P < 0.05).

Conclusions: These findings indicate that surgical correction of adolescent idiopathic scoliosis in eligible patients can lead not only to curve correction, but also to an increase self-esteem and life satisfaction.