Research in Adolescent Idiopathic Scoliosis

A Multicenter Study of the Outcomes of the Surgical Treatment Of Adolescent Idiopathic Scoliosis Using the Scoliosis Research Society (SRS) Outcome Instrument

Merola, Andrew A. MD*†; Haher, Thomas R. MD†; Brkaric, Mario MD*; Panagopoulos, Georgia PhD‡; Mathur, Samir MD*; Kohani, Omid MS III*; Lowe, Thomas G. MD§; Lenke, Larry G. MD∥; Wenger, Dennis R. MD¶; Newton, Peter O. MD#; Clements, David H. III, MD**; Betz, Randal R. MD††

Study Design. A multicenter study of the outcomes of the surgical treatment of adolescent idiopathic scoliosis using the Scoliosis Research Society Questionnaire (SRS 24).

Objective. To evaluate the patient based outcome of the surgical treatment of adolescent idiopathic scoliosis.

Summary of Background Data. A paucity of information exists with respect to patient measures of outcome regarding the surgical treatment of adolescent idiopathic scoliosis. To our knowledge, no prospective outcome study on this topic thus far exists.

Methods. Using the SRS 24 questionnaire, seven scoliosis centers agreed to prospectively assess outcome for surgically treated patients with adolescent idiopathic scoliosis. Data were collected before surgery and at 24 months after surgery. Data were analyzed using paired and independent samples t test for all seven SRS 24 questionnaire domains (Pain, General Self-Image, Postoperative Self-Image, Postoperative Function, Function From Back Condition, General Level of Activity, and Satisfaction) using Statistical Package for Social Science. The domains were analyzed with respect to the total cohort, gender, curve magnitude, and type of surgery using independent-samples t tests.

Results. A total of 242 patients were included in our analysis. A baseline preoperative pain level of 3.68 of 5 was found. This improved to 4.63 after surgery, representing an improvement of 0.95 points. Surgical intervention was associated with improving outcome when compared with preoperative status. Pain, General Self-Image, Function From Back Condition, and Level of Activity all demonstrated statistically significant improvement as compared with preoperative status (P < 0. 001). Overall, patients were highly satisfied with the results of surgery.

Conclusion. Preoperative pain exists in our adolescent scoliosis population. Pain scores were improved in our study population at the 2-year postsurgical follow-up. Statistically significant improvements were likewise seen in the General Self-Image, Function From Back Condition, and Level of Activity domains. The present study demonstrates the ability of surgery to improve the outcome of patients afflicted with adolescent idiopathic scoliosis.


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Spine: 15 September 2002 – Volume 27 – Issue 18 – pp 2046-2051