Quality of life in adolescent patients with idiopathic scoliosis after brace treatment: A meta-analysis

Abstract

Background: Whether brace-treated adolescents with idiopathic scoliosis (AIS) have improved quality of life (QoL) is still unknown. Thus, we conducted a meta-analysis to compare the QoL of brace-treated AIS patients with untreated AIS patients. The pain, self-image/appearance, mental health, function/activity, satisfaction with management, total score without satisfaction, and total score of patients were used to measure the QoL after the intervention.

Methods: Multiple electronic databases including PubMed, Web of Science, and Embase were searched for all years up to June 30, 2016. Articles in English that used the Scoliosis Research Society-22 (SRS-22) or a modified version of the SRS-22 questionnaire to evaluate the QoL differences between brace-treated AIS patients and untreated AIS patients were included in the meta-analysis. The Newcastle-Ottawa Scale was used in the quality of literature evaluation. The pooled standardized mean difference (SMD) with its corresponding 95% confidence interval (CI) for each parameter was computed. Egger test and Begg test were used to test for publication bias.

Results: The SRS-22 or a modified SRS-22 questionnaire was used to evaluate the QoL after surgery. There was no significant difference in pain (SMD = 0.123, 95% CI: -0.101 to 0.347, P = .282), self-image/appearance (SMD = 0.108, 95% CI: -0.116 to 0.332, P = .334), mental health (SMD = 0.031, 95% CI: -0.130 to 0.201, P = .365), function/activity (SMD = 0.202, 95% CI: -0.022 to 0.425, P = .077), and total score without satisfaction (SMD = 0.123, 95% CI: -0.232 to 0.478, P = .497) between the untreated (observation) and brace-treated AIS patients, whereas a significant difference was observed in satisfaction with management (SMD = 0.393, 95% CI: 0.127-0.659, P = .004) and total score (SMD = 0.312, 95% CI: 0.054-0.571, P = .018) between the 2 groups.

Conclusion: Our meta-analysis indicated that brace-treated AIS patients had a higher QoL. However, further analysis could not be performed because of insufficient data, such that we were unable to make subgroup analysis of QoL for different types of AIS and the therapeutic methods chosen by brace-treated AIS patients.

Figure 1

Flow chart describing the selection of eligible articles.

Figure 2

Forests plots of studies evaluating the difference in the pain (A) and self-image (B) between the untreated and brace-treated adolescents with idiopathic scoliosis patients after intervention.

Figure 3

Forest plots of studies assessing the difference in the function (A), mental health (B), and satisfaction with management (C) between the untreated and brace-treated adolescents with idiopathic scoliosis patients after intervention.

Figure 4

Forest plots of studies estimating the difference in the total score without satisfaction (A) and total score (B) between the untreated and brace-treated adolescents with idiopathic scoliosis patients after intervention.

Figure 5

Funnel plots of studies appraising the difference in the pain (A), self-image (B), function (C), and mental health (D) between the untreated and brace-treated adolescents with idiopathic scoliosis patients after intervention.

Figure 6

Funnel plots of studies assessing the difference in the satisfaction with management (A), total score without satisfaction (B), and total score (C) between the untreated and brace-treated adolescents with idiopathic scoliosis patients after intervention.