Patient Satisfaction After Surgical Correction of Adolescent Idiopathic Scoliosis

ArticleinSpine 36(12):965-8 · May 2011with26 Reads
DOI: 10.1097/BRS.0b013e3181e92b1d · Source: PubMed
Longitudinal cohort. The purpose of this study is to evaluate the relationship between change in SRS-22 domain scores and satisfaction with management in patients who underwent surgical correction for adolescent idiopathic scoliosis (AIS). The Scoliosis Research Society-22 (SRS-22) is a widely used instrument to measure clinical outcomes in patients with scoliosis. The relationship between patient satisfaction and changes in domain scores in the SRS-22 has not been previously reported. This is a longitudinal cohort of 745 patients with AIS who underwent surgical correction and had completed SRS-22 preoperative and 2 years postoperative. Patients who had a previous spine surgery were excluded. Wilcoxon tests were used to compare preop and 2-year postop scores. Spearman correlations were used to evaluate associations between change in SRS-22 domain scores from preoperative to 2 years postoperative and the 2-year SRS Satisfaction score. There were 622 females and 123 males with a mean age of 14.2 years and a mean Cobb angle of 54°. There was a statistically significant difference between paired preoperative and 2-year postoperative SRS domain scores. Spearman correlations between the change in SRS domain scores and the SRS Satisfaction score at 2 years postoperative were statistically significant but were low to moderate: Appearance = 0.284, Activity = 0.172, Pain = 0.260, Mental = 0.202, and Total = 0.398. Although there is a statistically significant change in all the SRS domain scores from preoperative to 2 years postsurgical correction of AIS, there was low to moderate associations between the change in any of the domain scores and patient satisfaction with treatment. This may be attributable to the prominent ceiling effect in the Satisfaction domain, or the lack of responsiveness of the SRS-22 to measure clinically relevant changes in activity, pain and mental health 2 years after correction of scoliosis in the adolescent population.
    • "Curiously, medication usage did not change significantly: daily opioid use was reported by 1 % across all time points and weekly or less frequent use of non-opioid medication also remained stable (23 % preoperatively, 25 % at 2-year follow-up and 25 % at 5-year follow-up) [61]. A longitudinal cohort of 745 patients with AIS treated surgically was followed for 2 years and the results of the pre-and postoperative SRS-22 compared [62]. The pre-and postoperative pain scores were 4.16 ± 0.71 and 4.31 ± 0.72, respectively. "
    [Show abstract] [Hide abstract] ABSTRACT: This broad narrative review addresses the relationship between adolescent idiopathic scoliosis (AIS) and back pain. AIS can be responsible for low back pain, particularly major cases. However, a linear relationship between back pain and the magnitude of the deformity cannot be expected for any individual patient. A large number of juvenile patients can remain pain-free. The long-term prognosis is rather benign for many cases and thus a tailored approach to the individual patient seems mandatory. The level of evidence available does not allow stringent recommendations for any of the disorders included in this review.
    Full-text · Article · Dec 2016
    • "It might be that the level of pain was expected or that the global satisfaction was associated with other factors. However, Carreon et al. (2011) found low to moderate associations between some of the domain scores of SRS-22 and scoliosis patient satisfaction with treatment. This contrasts to cancer patients, whose ratings of satisfaction with care have been shown strongly correlated to the quality of pain management ( Beck et al., 2010 ). "
    [Show abstract] [Hide abstract] ABSTRACT: Scoliosis surgery is one of the most extensive elective surgical processes performed on young people. Although there is a great store of knowledge of surgical techniques, patients' experiences of going through surgery have not been extensively studied. The aim of this study is to describe how a cohort of young people and their parents retrospectively rate postoperative pain and nausea and describe their experiences of scoliosis surgery. In a retrospective cohort study, 87 young people aged 8-25 years with scoliosis who underwent corrective surgery from 2004 to 2007 were invited to complete a questionnaire, as were their parents. The semistructured questionnaire dealt with experiences of pain, nausea, and global satisfaction pre- and posthospitalization, assessed by visual analogue scales. The free text commentaries were analyzed using qualitative content analysis. A total of 51 patients (59%) and 65 parents (75%) answered the questionnaires. Out of the completed questionnaires, 41 had idiopathic, 23 neuromuscular, and 6 other types of scoliosis. Postoperative patient-rated pain was severe 7.3 (median, interquartile range 5-8.4, visual analogue scale 0-10 cm), and the severe pain lasted for 5 (median, 2.7-7.0) days. Nausea was rated to a median of 5 (1.1-7.3) and lasted for a median of 3 (1-5.2) days. Global satisfaction was rated to a median of 3.2 (1.5-5.2). Postoperative pain was the most prominent issue, and present pain was found in 51% of respondents. Nausea and loss of appetite were common during the entire hospital stay. Waiting for the nurses' assistance, lack of control, and technical failures with the analgesia equipment caused discomfort. Parents experienced a lack of confidence in the nurses and felt helpless to support their child or relieve the child's suffering. Young people who underwent scoliosis surgery reported severe postoperative pain and nausea during the hospitalization period and persistent and recent onset pain after discharge, although they did not indicate global dissatisfaction with the hospital stay.
    Full-text · Article · Nov 2013
  • [Show abstract] [Hide abstract] ABSTRACT: Idiopathic scoliosis is a tridimensional trunk deformity, affecting both the spine and the rib cage. Low dose EOS stereoradiography is designed to assess the patient specific 3D geometry of the skeleton in standing position. The goal of this work is to improve the quantitative analysis of postoperative results in a routine clinical use, and to integrate the rib cage morphological analysis. Tools, methods and necessary proocols were first developed and validated to allow such an evaluation. In particular, the reliability of 3D measurements in severe scoliosis and instrumented spine were assessed. The modelization method was then applied to a series of adolescents operated for thoracic idiopathic scoliosis using posteromedial translation. The first part of the analysis focused on the instrumented spine, and included a new reference axis to estimate patients' global balance. The second part of the work aimed to describe the postoperative change of the sagittal cervical alignement. Significant improvement was found, correlated with thoracic kyphosis restoration. Finally, biplanar stereoradiography allowed a descriptive analysis of the endo and exothoracic morphology in a cohort of 80 adolescents with idiopathic scoliosis. Correlations between quantitative spinal and thoracic parameters and pulmonary function tests were investigated. The method was used in order to characterize the postoperative thoracic changes. This study confirms the interest of having in routine clinical use a 3D evaluation of the spine and the rib cage in the quantitative analysis of idiopathic scoliosis postoperative results.
    Article · Jun 2012 · Orthopaedic nursing / National Association of Orthopaedic Nurses
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