SRS-22r Scores in Nonoperated Adolescent Idiopathic Scoliosis Patients With Curves Greater Than Forty Degrees
| Autor: | Nicole A. Friel, Joanne A. Londino, James W. Roach, W. Timothy Ward, Maria M. Brooks, Tanya S. Kenkre |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Pain Cohort Studies 03 medical and health sciences Young Adult 0302 clinical medicine Quality of life Surveys and Questionnaires Medicine Raw score Humans Orthopedics and Sports Medicine Kyphosis Young adult 030222 orthopedics Cobb angle business.industry Minimal clinically important difference Evidence-based medicine Self Concept Mental Health Scoliosis Cohort Physical therapy Quality of Life Female Neurology (clinical) business 030217 neurology & neurosurgery Cohort study |
| Zdroj: | Spine. 42(16) |
| ISSN: | 1528-1159 |
| Popis: | Study design Case control comparative series. Objective Describe surgical range adolescent idiopathic scoliosis (AIS) patients electing to forgo surgery and compare health-related quality-of-life outcomes to a similar cohort of operated AIS patients by the same single surgeon. Summary of background data No data have been published either documenting SRS-22r scores of nonoperated patients with curves ≥40° or comparing these scores to a demographically similar operated cohort. Methods Individuals with curves ≥40°, age ≥18 years, and electing to forgo surgery were identified. All patients completed an SRS-22r questionnaire. This nonoperated cohort's SRS-22r scores were compared to those of a large demographically similar cohort operated by the same surgeon. Group differences between the SRS-22r scores were evaluated by comparing these to published Minimal Clinically Important Differences (MCID) for the SRS-22r. Results One hundred ninety subjects with nonoperated curves were compared to 166 individuals who underwent surgery. The nonoperated cohort averaged 23.5 years of age, averaged 7.7 years since curve reached 40°, and had an average 50° Cobb angle at last follow-up. No statistical significant differences were found between the groups on the Pain, Function, or Mental Health domains of the SRS-22r. Statistically significant differences in favor of the operative cohort were found for self-image, satisfaction, and total score. The observed group differences did not meet the established thresholds for minimal clinically important differences in any of the domain scores, the average total score, or raw scores. Conclusion There are no meaningful clinically significant differences in SRS-22r scores at average 8-year follow-up between AIS patients with curves ≥40° treated with or without surgery. These data in conjunction with an absence of long-term evidence of serious medical consequences with nonsurgical management of curves ≥40° should encourage surgeons to reevaluate the benefits of routine surgical care. Level of evidence 3. |
| Databáze: | OpenAIRE |
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