Evaluation of Patient Outcome and Satisfaction after Surgical Treatment of Adolescent Idiopathic Scoliosis Using Scoliosis Research Society-30

Document Type : RESEARCH PAPER


1 Iran university of medical sciences

2 Iran University of medical sciences

3 Bone Joint and related tissue research center, Shahid Beheshti university of medical sciences


 Adolescent idiopathic scoliosis (AIS) may lead to physical and mental problems. It also can adversely affect patient satisfaction and the quality of life. In this study, we assessed the outcomes and satisfaction rate after surgical treatment of AIS using scoliosis research society-30 questionnaire (SRS-30). 
 We enrolled 135 patients with AIS undergoing corrective surgery. Patients were followed for at least 2 years. We compared pre- and post-operative x-rays in terms of Cobb’s angles and coronal balance. At the last visit, patients completed the SRS-30 questionnaire. We then assessed the correlation between radiographic measures, SRS-30 total score, and patient satisfaction. 
Cobb’s angle and coronal balance improved significantly after surgery (<0.001). The scores of functional activity, pain, self-image/cosmesis, mental health, and satisfaction were 27±4.3, 26±2.5, 33±5.2, 23±3.5, and 13±1.8,  respectively. The total SRS-30 score was 127±13. Radiographic measures showed significant positive correlation with satisfaction and SRS-30 total scores ( P<0.05). There was also a positive correlation between. satisfaction and selfimage/cosmesis domain scores ( P<0.05). 
 The greater radiographic angles were corrected the higher SRS-30 total score and patient satisfaction were. It is intuitive that the appearance and cosmesis is of most important factor associated with patient satisfaction. 


  1. Gorman KF, Julien C, Moreau A. The genetic epidemiology of idiopathic scoliosis. Eur Spine J. 2012; 21(10):1905-19.
  2. Weiss HR, Goodall D. The treatment of adolescent idiopathic scoliosis (AIS) according to present evidence. A systematic review. Eur J Phys Rehabil Med. 2008;44(2):177-93.
  3. Riseborough EJ, Wynne-Davies R. A genetic survey of idiopathic scoliosis in Boston, Massachusetts. J Bone Joint Surg Am. 1973;55(5):974-82.
  4. Konieczny MR, Senyurt H, Krauspe R. Epidemiology of adolescent idiopathic scoliosis. J Child Orthop. 2013;7(1):3-9.
  5. Trobisch P, Suess O, Schwab F. Idiopathic scoliosis. Dtsch Arztebl Int. 2010;107(49):875-84.
  6. Ameri E, Behtash H, Mobini B, Bouzari B, Tari V. Patient satisfaction after scoliosis surgery. Med J Islam Repub Iran. 2008; 21(4) :177-84.
  7. Schwab F, Dubey A, Gamez L, El Fegoun AB, Hwang K, Pagala M, et al. Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population. Spine (Phila Pa 1976).  2005;30(9):1082-5.
  8. El-Hawary R, Chukwunyerenwa C. Update on Evaluation and Treatment of Scoliosis. Pediatr Clin North Am. 2014;61(6):1223-41.
  9. Suk SI, Kim JH, Kim SS, Lee JJ, Han YT. Thoracoplasty in thoracic adolescent idiopathic scoliosis. Spine (Phila Pa 1976).  2008;33(10):1061-7.
  10. Bullmann V, Halm HF, Niemeyer T, Hackenberg L, Liljenqvist U. Dual-rod correction and instrumentation of idiopathic scoliosis with the Halm-Zielke instrumentation. Spine (Phila Pa 1976).  2003; 28(12):1306-13.
  11. Lonner BS, Auerbach JD, Estreicher M, Milby AH, Kean KE. Video-assisted thoracoscopic spinal fusion compared with posterior spinal fusion with thoracic pedicle screws for thoracic adolescent idiopathic scoliosis. J Bone Joint Surg Am. 2009;91(2):398-408.
  12. Misterska E, Glowacki M, Harasymczuk J. Personality characteristics of females with adolescent idiopathic scoliosis after brace or surgical treatment compared to healthy controls. Med Sci Monit. 2010;16(12):CR606-15.
  13. Weinstein SL, Dolan LA, Cheng JC, Danielsson A, Morcuende JA. Adolescent idiopathic scoliosis. Lancet. 2008; 371(9623):1527-37.
  14. Danielsson AJ, Wiklund I, Pehrsson K, Nachemson AL. Health-related quality of life in patients with adolescent idiopathic scoliosis: a matched follow-up at least 20 years after treatment with brace or surgery. Eur Spine J. 2001;10(4):278-88.
  15. Tones M, Moss N, Polly DW Jr. A review of quality of life and psychosocial issues in scoliosis. Spine (Phila Pa 1976). 2006;31(26):3027-38.
  16. Matsunaga S, Hayashi K, Naruo T, Nozoe S, Komiya S. Psychologic management of brace therapy for patients with idiopathic scoliosis. Spine (Phila Pa 1976).  2005; 30(5):547-50.
  17. Koch KD, Buchanan R, Birch JG, Morton AA, Gatchel RJ, Browne RH. Adolescents undergoing surgery for idiopathic scoliosis: how physical and psychological characteristics relate to patient satisfaction with the cosmetic result. Spine (Phila Pa 1976).  2001;26(19):2119-24.
  18. Merola AA, Haher TR, Brkaric M, Panagopoulos G, Mathur S, Kohani O, et al. A multicenter study of the outcomes of the surgical treatment of adolescent idiopathic scoliosis using theScoliosis Research Society (SRS) outcome instrument. Spine (Phila Pa 1976). 2002;27(18):2046-51.
  19. Misterska E, Głowacki M, Harasymczuk J. Assessment of spinal appearance in female patients with adolescent idiopathic scoliosis treated operatively. Med Sci Monit. 2011;17(7):CR404-10.
  20. Kinel E, Kotwicki T, Podolska A, Białek M, Stryła W. Quality of life and stress level in adolescents with idiopathic scoliosis subjected to conservative treatment. Stud Health Technol Inform. 2012; 176: 419-22.
  21. Spanyer JM, Crawford CH 3rd, Canan CE, Burke LO, Heintzman SE, Carreon LY. Health-Related Quality-of-Life Scores, Spine-Related Symptoms, and Reoperations in Young Adults 7 to 17 Years After Surgical Treatment of Adolescent Idiopathic Scoliosis. Am J Orthop (Belle Mead NJ). 2015;44(1):26-31.
  22. Lee JS, Lee DH, Suh KT, Kim JI, Lim JM, Goh TS. Validation of the Korean version of the Scoliosis Research Society-22 questionnaire. Eur Spine J. 2011; 20(10):1751-6.
  23. Haher TR, Gorup JM, Shin TM, Homel P, Merola AA, Grogan DP, et al. Results of the Scoliosis Research Society instrument for evaluation of surgical outcome in adolescent idiopathic scoliosis. A multicenter study of 244 patients. Spine (Phila Pa 1976). 1999;24(14):1435-40.
  24. Asher MA, Min Lai S, Burton DC. Further development and validation of the Scoliosis Research Society (SRS) outcomes instrument. Spine (Phila Pa 1976). 2000; 25(18):2381-6
  25. Scoliosis Research Society. Adolescent idiopathic scoliosis. March 31, 2009. Available at: http://www.srs.org/professionals/education/ adolescent/idiopathic/. Accessed June 15, 2011.
  26. Carriço G, Meves R, Avanzi O. Cross-cultural adaptation and validity of an adapted Brazilian Portuguese version of Scoliosis Research Society-30 questionnaire. Spine (Phila Pa 1976).   2012; 37(1):E60-3.
  27. Mousavi SJ, Mobini B, Mehdian H, Akbarnia B, Bouzari B, Askary-Ashtiani A, et al. Reliability and validity of the persian version of the scoliosis research society-22r questionnaire. Spine (Phila Pa 1976). 2010;35(7):784-9.
  28. Rothenfluh DA, Neubauer G, Klasen J, Min K. Analysis of internal construct validity of the SRS-24 questionnaire. Eur Spine J. 2012;21(8):1590-5.
  29. Sathira-Angkura V, Pithankuakul K, Sakulpipatana S, Piyaskulkaew C, Kunakornsawat S. Validity and reliability of an adapted Thai version of Scoliosis Research Society-22 questionnaire for adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2012; 37(9):783-7.
  30. Bridwell KH, Berven S, Glassman S, Hamill C, Horton WC 3rd, Lenke LG, et al. Is the SRS-22 instrument responsive to change in adult scoliosis patients having primary spinal deformity surgery? Spine (Phila Pa 1976). 2007;32(20):2220-5.
  31. Omidi Kashani F, Ghayem Hasankhani E, Baradaran A,  Baghban N. Clinical Outcomes of Surgery in Young Patients With Spinal Deformity. Razavi Int J Med. 2015;2(4):e23878.
  32. Carreon LY, Sanders JO, Diab M, Sturm PF, Sucato DJ; Spinal Deformity Study Group. Patient satisfaction after surgical correction of adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2011; 36(12):965-8.
  33. Gorzkowicz B, Kołban M, Szych Z. Assessment of quality of life in patients with idiopathic scoliosis treated operatively. Ortop Traumatol Rehabil. 2009; 11(6):530-41.
  34. Sanders JO, Carreon LY, Sucato DJ, Sturm PF, Diab M; Spinal Deformity Study Group. Preoperative and perioperative factors effect on adolescent idiopathic scoliosis surgical outcomes. Spine (Phila Pa 1976).  2010;35(20):1867-71.