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. 2023 May 15;48(10):683-687.
doi: 10.1097/BRS.0000000000004620. Epub 2023 Mar 13.

SRS-22r Self-Image After Surgery for Adolescent Idiopathic Scoliosis at 10-year Follow-up

Lauren E Stone  1 , Vidyadhar V Upasani  2 , Joshua M Pahys  3 , Nicholas D Fletcher  4 , Stephen G George  5 , Suken A Shah  6 , Tracey P Bastrom  2 , Carrie E Bartley  2 , Lawrence G Lenke  7 , Peter O Newton  2 , Michael P Kelly  2 ; Harms Study Group
Collaborators, Affiliations

SRS-22r Self-Image After Surgery for Adolescent Idiopathic Scoliosis at 10-year Follow-up

Lauren E Stone et al. Spine (Phila Pa 1976). .

Abstract

Study design: Retrospective cohort.

Objective: To examine SRS-Self Image scores at up to 10 years after surgery for adolescent idiopathic scoliosis (AIS).

Summary of background data: Self-image is complex with implications for surgical and patient-reported outcomes after AIS surgery. Surgically modifiable factors that impact self-image are inconsistently reported in the literature with few longer-term reports. We examined the rate and durability of self-image improvement.

Materials and methods: An AIS registry was queried for patients with up to 10 years of follow-up after AIS surgery. A mixed effects model estimated change in SRS-22 Self Image from baseline to 6 weeks, 1 year, 2 years, 5 years, and 10 years. All enrolled patients contributed data to the mixed effects models. A sub-analysis of patients with 1-year and 10-year follow-up evaluated worsening/static/improved SRS-22 Self Image scores examined stability of scores over that timeline. Baseline demographic data and 1-year deformity magnitude data were compared between groups using parametric and nonparametric tests as appropriate.

Results: Data from 4608 patients contributed data to the longitudinal model; 162 had 1-year and 10-year data. Mean SRS-Self Image improvement at 10-year follow-up was 1.0 (95% CI: 0.9-1.1) point. No significant changes in Self-Image domain scores were estimated from 1-year to 10-year (all P >0.05) postoperative. Forty (25%) patients had SRS-Self Image worsening from 1 year to 10 years, 36 (22%) improved, and 86 (53%) were unchanged. Patients who worsened over 10 years had lower SRS-Self Image at baseline than those unchanged at enrollment (3.3 vs. 3.7, P =0.007). Neither radiographic parameters nor SRS-Mental Health were different at baseline for the enrolled patients.

Conclusion: Ten years after surgery, 75% of patients reported similar or better SRS-Self Image scores than one year after surgery. Nearly 25% of patients reported worsening self-image at 10 years. Patients who worsened had lower baseline SRS-Self Image scores, without radiographic or mental health differences at baseline or follow-up.

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Conflict of interest statement

The authors report no conflicts of interest.

References

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    1. Bastrom TP, Bartley CE, Newton PO, et al. Patient-reported SRS-24 outcomes scores after surgery for adolescent idiopathic scoliosis have improved since the new millennium. Spine Deform. 2019;7:917–22.
    1. Payne WK III, Ogilvie JW, Resnick MD, et al. Does scoliosis have a psychological impact and does gender make a difference? Spine (Phila Pa 1976). 1997;22:1380–4.
    1. Rushton PR, Grevitt MP. What is the effect of surgery on the quality of life of the adolescent with adolescent idiopathic scoliosis? A review and statistical analysis of the literature. Spine (Phila Pa 1976). 2013;38:786–94.