Adolescents undergoing surgery for idiopathic scoliosis - How physical andpsychological characteristics relate to patient satisfaction with the cosmetic result

Study Design. Patient satisfaction with the cosmetic result of spinal fusio n surgery was studied in 42 cases of adolescent idiopathic scoliosis. Neutr al or dissatisfied patients were compared with satisfied patients on severa l physical and psychological characteristics. Objectives. To determine whether adolescents generally report satisfaction with the postoperative appearance of their back after the correction of sev ere curves and whether preoperative medical and/or psychological factors di stinguish between patients who will report satisfaction with the cosmetic s urgical result from those who will report neutrality or dissatisfaction. Summary of Background Data. Previous reports emphasize the need for medical outcomes research that evaluates both patient satisfaction and technical s uccess. Patient satisfaction with spinal surgery has largely been evaluated in retrospective studies and most consistently related to postoperative co smesis and degree of curve correction. Methods. Forty-two adolescents with idiopathic scoliosis without comorbidit y, who were 12 years 6 months of age or older, and who did not require both anterior and posterior spinal fusion, were studied preoperatively and post operatively by physical and psychological measurements. Results. Of patients undergoing surgical correction of severe curves, 73% r eported satisfaction with the cosmetic result. Neutral or dissatisfied pati ents were more likely than satisfied patients to have a lower body mass ind ex (P < 0.05), to be younger in menarcheal status (P < 0.05), and have a Ki ng II or King III curve type. Preoperative psychological difficulties (P < 0.05) and unmet expectations regarding the postoperative cosmesis (P < 0.05 ) were more common among neutral or dissatisfied patients. Conclusions. Most adolescents with idiopathic scoliosis expressed satisfact ion with the cosmetic surgical result. Preoperative physical characteristic s, psychological difficulties, and unrealistic expectations regarding posto perative cosmesis are associated with patient neutrality or dissatisfaction .