title: Improvement in quality of life following surgery for adolescent idiopathic scoliosis.
abstract: METHODS
  We used the Climent Quality of Life for Spinal Deformities Scale prospectively in a nonrandomized prospective comparative cohort of operative versus observational management of adolescent idiopathic scoliosis.
  
  
  OBJECTIVE
  To compare the change in disease-specific quality of life associated with operating on adolescents with idiopathic scoliosis, to the change in disease-specific quality of life among observed scoliosis patients with a similar 2-year follow-up period.
  
  
  BACKGROUND
  The immediate effect of scoliosis surgery on quality of life from a patient perspective has not been properly documented but should play a role in the patient's decision to operate.
  
  
  METHODS
  At a single tertiary referral children's hospital spinal clinic, 119 patients undergoing scoliosis surgery and 42 patients undergoing observation only for scoliosis were enrolled in a prospective study, including preoperative and postoperative spine-specific quality of life. Change in quality of life after 2 years of follow-up among operated versus observed patients (adjusted for baseline quality of life) was used to estimate the short-term benefit of scoliosis surgery.
  
  
  RESULTS
  The operated group experienced an increase in quality of life of 4.3 points (95% confidence interval, 0.69-7.88) on the 115-point Climent scale. Although statistically significant, this increase was lower than the 5.5-point cutoff we had defined a priori as clinically significant.
  
  
  CONCLUSIONS
  Scoliosis surgery results in a small increase in spine-related quality of life at 2 years. This increase is of questionable clinical significance. Decisions to operate on adolescents with scoliosis should acknowledge modest expectations about short-term gains in quality of life.
authors.affiliation: Hospital for Sick Children, Toronto, Ontario, Canada. andrew.howard@sickkids.ca
authors.forename: Andrew
authors.initials: A
authors.lastname: Howard
authors.forename: Sandra
authors.initials: S
authors.lastname: Donaldson
authors.forename: Douglas
authors.initials: D
authors.lastname: Hedden
authors.forename: Derek
authors.initials: D
authors.lastname: Stephens
authors.forename: Benjamin
authors.initials: B
authors.lastname: Alman
authors.forename: James
authors.initials: J
authors.lastname: Wright
mesh_terms: D000293:Adolescent; D001915:Braces; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D015203:Reproducibility of Results; D012600:Scoliosis / Q000523:psychology* / Q000601:surgery* / Q000628:therapy; D013123:Spinal Fusion / Q000523:psychology*; D011795:Surveys and Questionnaires / Q000592:standards; D016896:Treatment Outcome