Document Detail

How do idiopathic scoliosis patients who improve after surgery differ from those who do not exceed a minimum detectable change?
MedLine Citation:
PMID:  21932063     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: The minimum detectable change (MDC) of the SRS-22 subtotal score is 6.8 points. With the use of this value, patients who have undergone surgery for idiopathic scoliosis can be dichotomized into two groups: the successful (S) group (those who have reached or exceeded this limit) and the unsuccessful (Un-S) group (those in whom the change was smaller). The aim of this study was to analyze the clinical and radiological differences between these patient groups, as well as those related to the surgical technique.
MATERIAL AND METHODS: The study included 91 patients (77 women and 14 men, mean age 18.1 years). All patients completed the SRS-22 questionnaire preoperatively and at follow-up (mean 45.6 months). In addition, radiological and surgical data were collected: levels instrumented, number of fused vertebrae, and use of thoracoplasty.
RESULTS: Based on the MDC of the SRS-22 subtotal score, patients were assigned to the Un-S group (44 cases, 48.4%) or S group (47 cases). Groups were similar in age, sex, number of fused vertebrae, percentage of patients who underwent thoracoplasty, and the upper and lower instrumented levels. The magnitude of the major curve and percentage of correction after surgery were also similar (Un-S group 62.3º, 53.2%; S group 64.3º, 49.9%). As compared to Un-S group, S patients had a poorer preop score in all the SRS-22 domains, and a clinically significant postop improvement in pain, perceived body image, mental health, and subtotal score. In contrast, the Un-S group showed a worsening of pain, function, mental health, and subtotal score, and a clinically nonsignificant improvement in perceived body image on the follow-up questionnaire. There were no significant differences in the satisfaction domain score between groups (4.36 vs. 4.62). On ROC curve analysis, a preop subtotal score of 74 points predicted allocation to the S or Un-S group at follow-up with 79% sensitivity and 76% specificity.
CONCLUSION: The preop subtotal score of the SRS-22 is a good predictor of the clinical response to surgery.
Joan Bago; Francisco Javier Sanchez Perez-Grueso; Ferran Pellise; Esther Les
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study     Date:  2011-09-20
Journal Detail:
Title:  European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society     Volume:  21     ISSN:  1432-0932     ISO Abbreviation:  Eur Spine J     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-06     Completed Date:  2012-09-24     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  9301980     Medline TA:  Eur Spine J     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  50-6     Citation Subset:  IM    
Spine Unit, Hospital Vall d'Hebron, Barcelona, Spain.
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MeSH Terms
Follow-Up Studies
Preoperative Care
Quality of Life / psychology*
Questionnaires / standards
Scoliosis* / epidemiology,  psychology,  surgery
Spinal Fusion / psychology*
Treatment Outcome
Young Adult

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