Tracey P Bastrom1, Burt Yaszay2, Suken A Shah3, Firoz Miyanji4, Baron S Lonner5, Michael P Kelly6, Amer Samdani7, Jahangir Asghar8, Peter O Newton1. 1. Rady Children's Hospital-San Diego, 3020 Children's Way, San Diego, CA 92123, USA. 2. Rady Children's Hospital-San Diego, 3020 Children's Way, San Diego, CA 92123, USA. Electronic address: byaszay.rady@gmail.com. 3. Alfred I. duPont Hospital for Children, 1600 Rockland Rd, Wilmington, DE 19803, USA. 4. British Columbia Children's Hospital, 4480 Oak St, Vancouver, BC V6H 3N1, Canada. 5. Scoliosis and Spine Associates, 820 2nd Ave, New York, NY 10017, USA. 6. Washington University, 1 Brookings Dr, St. Louis, MO 63130, USA. 7. Shriner's Hospital for Children, 3551 N Broad St, Philadelphia, PA 19140, USA. 8. Nicklaus Children's Hospital, 3100 S.W. 62nd Ave, Miami, FL 33155, USA.
Abstract
STUDY DESIGN: Retrospective review of prospectively collected data. OBJECTIVE: To determine whether adolescent idiopathic scoliosis (AIS) patients with active complications at two-year follow-up demonstrate lower Scoliosis Research Society (SRS-22) questionnaire scores. SUMMARY OF BACKGROUND DATA: There is limited evidence as to whether the SRS-22 is sensitive to complications in postoperative AIS patients. METHODS: Surgical patients with SRS-22 scores completed at two-year follow-up were included. Five groups were created: no complication, minor complication resolved by 2 years, major complication resolved by 2 years, minor complication active, and major complication active at 2 years. Likelihood of reaching a minimal clinically important difference (MCID) for pain (0.20) and self-image (0.98) was evaluated. RESULTS: 1,481 patients were identified. Major complications active at two years existed in 2.2% of patients. These patients had the lowest score in all domains and total scores (p < .05). If a minor complication was active, scores were impacted for pain, self-image, satisfaction, and total (p < .05). No differences were found between no complication and resolved complications. Patients with active major complications were more likely to have a pain score that worsened from pre- to two years reaching MCID (52%) compared to the other four groups (range 18%-29%, odds ratio [OR] 3.6, p < .001). They also had a nonsignificant decreased rate of improvement of self-image score at an MCID level (42% vs. range 51%-66%, OR 0.56, p = .10). CONCLUSIONS: When timing is considered, the SRS-22 demonstrates the ability to discriminate between patients with and without a complication. Active experience of a major complication impacted SRS-22 scores, in particular, the rate of worsening scores for pain, self-image, function, and total score. LEVEL OF EVIDENCE: Level III.
STUDY DESIGN: Retrospective review of prospectively collected data. OBJECTIVE: To determine whether adolescent idiopathic scoliosis (AIS) patients with active complications at two-year follow-up demonstrate lower Scoliosis Research Society (SRS-22) questionnaire scores. SUMMARY OF BACKGROUND DATA: There is limited evidence as to whether the SRS-22 is sensitive to complications in postoperative AISpatients. METHODS: Surgical patients with SRS-22 scores completed at two-year follow-up were included. Five groups were created: no complication, minor complication resolved by 2 years, major complication resolved by 2 years, minor complication active, and major complication active at 2 years. Likelihood of reaching a minimal clinically important difference (MCID) for pain (0.20) and self-image (0.98) was evaluated. RESULTS: 1,481 patients were identified. Major complications active at two years existed in 2.2% of patients. These patients had the lowest score in all domains and total scores (p < .05). If a minor complication was active, scores were impacted for pain, self-image, satisfaction, and total (p < .05). No differences were found between no complication and resolved complications. Patients with active major complications were more likely to have a pain score that worsened from pre- to two years reaching MCID (52%) compared to the other four groups (range 18%-29%, odds ratio [OR] 3.6, p < .001). They also had a nonsignificant decreased rate of improvement of self-image score at an MCID level (42% vs. range 51%-66%, OR 0.56, p = .10). CONCLUSIONS: When timing is considered, the SRS-22 demonstrates the ability to discriminate between patients with and without a complication. Active experience of a major complication impacted SRS-22 scores, in particular, the rate of worsening scores for pain, self-image, function, and total score. LEVEL OF EVIDENCE: Level III.