학술논문
SRS-22r Self-Image After Surgery for Adolescent Idiopathic Scoliosis at 10-year Follow-up
Document Type
Academic Journal
Author
Stone, Lauren E.; Upasani, Vidyadhar V.; Pahys, Joshua M.; Fletcher, Nicholas D.; George, Stephen G.; Shah, Suken A.; Bastrom, Tracey P.; Bartley, Carrie E.; Lenke, Lawrence G.; Newton, Peter O.; Kelly, Michael P.; Buckland, Aaron; Samdani, Amer; Jain, Amit; Lonner, Baron; Roye, Benjamin; Yaszay, Burt; Reilly, Chris; Hedequist, Daniel; Sucato, Daniel; Clements, David; Miyanji, Firoz; Shufflebarger, Harry; Flynn, Jack; Asghar, John; Mac Thiong, Jean Marc; Pahys, Joshua; Harms, Juergen; Bachmann, Keith; Lenke, Lawrence; Karol, Lori; Abel, Mark; Erickson, Mark; Glotzbecker, Michael; Kelly, Michael; Vitale, Michael; Michelle Marks, PT; Gupta, Munish; Fletcher, Nicholas; Larson, Noelle; Cahill, Patrick; Sponseller, Paul; Gabos, Peter; Newton, Peter; Sturm, Peter; Betz, Randal; Parent, Stefan; George, Stephen; Hwang, Steven; Shah, Suken; Garg, Sumeet; Errico, Tom; Upasani, Vidyadhar
Source
Spine. May 15, 2023 48(10):683-687
Subject
Language
English
ISSN
0362-2436
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.