• Roland K Pratt, R Geoffrey Burwell, Ashley A Cole, and John K Webb.
• School of Biomedical Sciences, Nottingham University, Queen's Medical Centre, University Hospital, Nottingham, England. rolandfi@clara.net
• Spine. 2002 Jul 15;27(14):1543-50; discussion 1551-2.

Study DesignThis prospective 2-year follow-up study evaluated patients treated surgically for adolescent idiopathic scoliosis (AIS).ObjectiveTo report parents' perception, patients' perception, and pain and disability before and after surgery and to examine their relationship to anthropometric, back surface, and radiographic measurements.Summary Of Background DataNo longitudinal studies have examined these factors and their interrelationships.MethodsBetween 1995 and 1999, 39 AIS patients treated by anterior or posterior USS (Universal Spine System, Stratec, Oberdorf, Switzerland) instrumentation had complete prospective questionnaire, back surface, and radiographic appraisal.ResultsThe preoperative Visual Analogue Score (VAS) for pain-predominantly mild backache-was 24 mm (range, 0-78 mm), and the Oswestry Disability Index (ODI) score was 9.2% (0-44.4%). Patients and parents wanted surgery to correct spinal curvature, stop curve progression, and correct the rib-hump (thoracic) and hip and waist asymmetry (thoracolumbar curves). The maximum angle of trunk inclination correlated with VAS and with short-form McGill Pain Questionnaire scores for thoracic curves (P = 0.005, Spearman rank correlation coefficient). Apical vertebral translation correlated with short-form McGill scores and ODI for thoracolumbar curves (P < 0.006, Spearman rank correlation coefficient). Parents rated scoliosis problems more severely than did their children (P < 0.0001, repeated measures of multivariate analysis of variants). There was no change in body image, VAS, ODI, or short-form McGill scores by 2 years' follow-up. Parents and patients perceived scoliosis problems to be less by 2 years' follow-up (P < 0.0005, Wilcoxon matched-pairs signed ranks test). The preoperative surface asymmetry score correlated with the patients' grading of their rib-hump (P = 0.007).ConclusionsBack pain incidence was higher than reported for healthy adolescents. Oswestry Disability Index was within normal adult limits. Pain varied by curve type, related to the maximum angle of trunk inclination and the maximum apical vertebral translation. After surgery, back pain and ODI were unchanged, but concerns regarding scoliosis were reduced.

18 keywords...

hide…