• Rudo Duri, Kaitlyn Brown, Megan Johnson, and Amy McIntosh.
• Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX 75219, USA.
• Spine Deform. 2019 Jan 1; 7 (1): 80-83.

Study DesignAdolescent idiopathic scoliosis (AIS) patients undergoing spine fusion (SF) had their data prospectively collected. The SRS Spine Appearance Questionnaire (SAQ) was the primary outcome measure. The data were reviewed in a retrospective manner.ObjectivesPatient concerns about breast/chest wall asymmetry in AIS is high. This study sought to determine the improvement after spinal fusion (SF).SummaryBreast/chest wall asymmetry is a significant physical deformity associated with AIS. No literature exists on patient satisfaction related to improved breast/chest wall appearance after SF surgery.Methods474 patients undergoing SF for AIS from 2006 to 2014 completed the SRS SAQ preoperation and at two years postoperation. Data were prospectively collected and reviewed in a retrospective manner. The SAQ includes two statements regarding breast/chest wall asymmetry (19 and 20). Statistical analysis was performed to determine a relationship between improved SAQ responses and any clinical/radiographic or surgical parameters.Results395 females and 79 males (14.4 ± 2.0 years) with preoperation and two-year postoperation Cobb angle 60.6 ± 11.5 and 26.6 ± 12.1 were reviewed. Before surgery, 68.0% of patients identified with the statement "I want to have more even breasts" compared with 37.0% at two years postoperation. In addition, 78.9% identified with the statement "I want to have a more even chest in the front" preoperatively compared with 34.0% at two years postoperation. Positive preoperative responses correlated with scoliometer (p = .029) (p = .044) and Cobb angle of the major curve (p = .048 and p = .006). At two years postoperation, there was a significant number of patients (76%) who had at least a two-point decrease in their response to either statement (p < .0001).ConclusionBreast asymmetry is a significant concern of many AIS patients, including males, and correlates with preoperative curve magnitude. SF results in significant improvement in patient perception of breast/chest wall asymmetry, with 76% of patients reporting good outcomes at two years postoperation.Level Of EvidenceLevel 2.Copyright © 2018 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

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