Patients' perceptions of overall function, pain, and appearance after primary posterior instrumentation and fusion for idiopathic scoliosis

Study Design. This outcome study used patients' responses to the Scoliosis Research Society Outcomes Instrument to discriminate among patients who had undergone surgery for correction of juvenile or adolescent idiopathic scol iosis. Objectives. To evaluate a surgically treated population by using the SRS Ou tcomes Instrument. Summary of Background Data. The Scoliosis Research Society outcomes instrum ent was developed to help evaluate patient-perceived outcomes after treatme nt for idiopathic scoliosis. It includes 24 questions designed to investiga te seven domains. Methods. Eligible patients underwent posterior surgery for the first time b efore their 21st birthdays. One surgeon performed the surgery at one medica l center. Of 168 eligible patients, 121 (72%) completed the Scoliosis Resea rch Society outcomes questionnaire. Results. Females reported better outcomes in the function after surgery (P = 0.005) and self-image after surgery (P = 0.01) domains. Preoperative curv e pattern comparison demonstrated a significant difference in self-image af ter surgery among four groups classified according to curve pattern. The th oracolumbar and lumbar group recorded image scores of 5, the highest possib le score, 85% of the time. The King-Moe (KM) V group scored 5, 75% of the t ime; the KM I and II group 48%; and the KM III and IV group 46% (P = 0.0015 ). After eliminating confounding variables, it was found that white patient s reported experiencing less pain in follow-up than did black patients (P = 0.0098). Results were also suggestive that less pain was associated with i ncreased number of fused vertebrae (P = 0.027). Conclusions. The strongest predictors of self-perceived favorable outcome a mong patients were female sex and white race. It is also suggested that lon ger fusions to L1 through L3 lead to less perceived pain than with shorter fusions.