title: Adolescents undergoing surgery for idiopathic scoliosis: how physical and psychological characteristics relate to patient satisfaction with the cosmetic result.
abstract: METHODS
  Patient satisfaction with the cosmetic result of spinal fusion surgery was studied in 42 cases of adolescent idiopathic scoliosis. Neutral or dissatisfied patients were compared with satisfied patients on several physical and psychological characteristics.
  
  
  OBJECTIVE
  To determine whether adolescents generally report satisfaction with the postoperative appearance of their back after the correction of severe curves and whether preoperative medical and/or psychological factors distinguish between patients who will report satisfaction with the cosmetic surgical result from those who will report neutrality or dissatisfaction.
  
  
  BACKGROUND
  Previous reports emphasize the need for medical outcomes research that evaluates both patient satisfaction and technical success. Patient satisfaction with spinal surgery has largely been evaluated in retrospective studies and most consistently related to postoperative cosmesis and degree of curve correction.
  
  
  METHODS
  Forty-two adolescents with idiopathic scoliosis without comorbidity, 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 postoperatively by physical and psychological measurements.
  
  
  RESULTS
  Of patients undergoing surgical correction of severe curves, 73% reported satisfaction with the cosmetic result. Neutral or dissatisfied patients were more likely than satisfied patients to have a lower body mass index (P < 0.05), to be younger in menarcheal status (P < 0.05), and have a King 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 satisfaction with the cosmetic surgical result. Preoperative physical characteristics, psychological difficulties, and unrealistic expectations regarding postoperative cosmesis are associated with patient neutrality or dissatisfaction.
authors.affiliation: Texas Scottish Rite Hospital for Children, Dallas, Texas 75219-3993, USA.
authors.forename: K D
authors.initials: KD
authors.lastname: Koch
authors.forename: R
authors.initials: R
authors.lastname: Buchanan
authors.forename: J G
authors.initials: JG
authors.lastname: Birch
authors.forename: A A
authors.initials: AA
authors.lastname: Morton
authors.forename: R J
authors.initials: RJ
authors.lastname: Gatchel
authors.forename: R H
authors.initials: RH
authors.lastname: Browne
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000503:physiopathology; D008141:Lordosis / Q000503:physiopathology; D008297:Male; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000523:psychology*; D012600:Scoliosis / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery*; D012649:Self Concept; D013123:Spinal Fusion / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome