Do you see what I see? Looking at scoliosis surgical outcomes through orthopedists' eyes.
METHODS
A prospective study evaluated orthopedists' ratings of preoperative and postoperative cosmesis in adolescents undergoing posterior or anterior spinal fusion for idiopathic scoliosis. Measures evaluated how orthopedists rated outcome in relation to patient satisfaction with the surgical result.


BACKGROUND
The reliability of physician-derived data as a method for evaluating scoliosis surgical outcomes has not been sufficiently explored and has not been related to patient satisfaction ratings with the postoperative result.


OBJECTIVE
The purpose of this study was to determine 1) the intrarater and interrater reliability estimates of orthopedists' ratings of scoliosis surgical outcomes and 2) the association between orthopedists' ratings and patient satisfaction ratings with the postoperative cosmesis.


METHODS
Six orthopedists independently rated preoperative and postoperative color slides for cosmetic deformity in 41 patients with adolescent idiopathic scoliosis. Patients rated their satisfaction with the postoperative cosmesis 5 to 11 months after surgery.


RESULTS
The intrarater and interrater reliabilities of orthopedists' assessments of scoliosis surgical outcomes ranged from fair to poor. Orthopedists' assessments of postoperative shoulder asymmetry significantly correlated with patient satisfaction ratings of cosmetic appearance following surgical correction of severe curves. Patient satisfaction ratings were unrelated to orthopedists' ratings of scar appearance, cosmetic deformity, and preoperative to postoperative cosmetic change.


CONCLUSIONS
Intrarater and interrater reliability estimates were unacceptably low when evaluating spinal surgical outcomes in these 41 patients. Overall, orthopedists' ratings were not significantly correlated with patient satisfaction ratings of the postoperative result.
Buchanan
Renee
R
Texas Scottish Rite Hospital for Children, Dallas 75219, USA.
Birch
John G
JG
Morton
Anne A
AA
Browne
Richard H
RH
D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D009985:Orthopedics; D017060:Patient Satisfaction; D011446:Prospective Studies; D012600:Scoliosis / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome