title: Male-female differences in Scoliosis Research Society-30 scores in adolescent idiopathic scoliosis.
abstract: METHODS
  Longitudinal cohort study.
  
  
  OBJECTIVE
  To compare functional outcomes between male and female patients before and after surgery for adolescent idiopathic scoliosis (AIS).
  
  
  BACKGROUND
  There is no clear consensus in the existing literature with respect to sex differences in functional outcomes in the surgical treatment of AIS.
  
  
  METHODS
  A prospective, consecutive, multicenter database of patients who underwent surgical correction for adolescent idiopathic scoliosis was analyzed retrospectively. All patients completed Scoliosis Research Society-30 (SRS-30) questionnaires before and 2 years after surgery. Patients with previous spine surgery were excluded. Data were collected for sex, age, Risser grade, previous bracing history, maximum preoperative Cobb angle, curve correction at 2 years, and SRS-30 domain scores. Paired sample t tests were used to compare preoperative and postoperative scores within each sex. Independent sample t tests were used to compare scores between sexes. A P value of <0.05 was considered statistically significant.
  
  
  RESULTS
  Seven hundred forty-four patients (621 females and 123 males) were included. On average, males were 1 year older than females. There were no differences between sexes in Risser grade, bracing history, maximum curve magnitude, or correction after surgery. Both males and females had similar improvement in all SRS-30 domains after surgery. Self-image/appearance had the greatest relative improvement. Males had better self-image/appearance scores preoperatively, better pain scores at 2 years, and better mental health and total scores both preoperatively and at 2 years. Both males and females were similarly satisfied with surgery.
  
  
  CONCLUSIONS
  Males treated with surgery for AIS report better preoperative self-image, less postoperative pain, and better mental health than females. These differences may be clinically significant. For both males and females, the most beneficial effect of surgery is improved self-image/appearance. Overall, the benefits of surgery for AIS are similar for both sexes.
authors.affiliation: Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Roberts
authors.forename: Jason W
authors.initials: JW
authors.lastname: Savage
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Schwartz
authors.forename: Leah Y
authors.initials: LY
authors.lastname: Carreon
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Sucato
authors.forename: James O
authors.initials: JO
authors.lastname: Sanders
authors.forename: Benjamin Stephens
authors.initials: BS
authors.lastname: Richards
authors.forename: Lawrence G
authors.initials: LG
authors.lastname: Lenke
authors.forename: John B
authors.initials: JB
authors.lastname: Emans
authors.forename: Stefan
authors.initials: S
authors.lastname: Parent
authors.forename: John F
authors.initials: JF
authors.lastname: Sarwark
mesh_terms: D000293:Adolescent; D002170:Canada; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D019637:Orthopedic Procedures; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D017060:Patient Satisfaction; D020127:Recovery of Function; D012189:Retrospective Studies; D012600:Scoliosis / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D012649:Self Concept; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States