title: Prospective evaluation of quality of life in adolescent idiopathic scoliosis before and after surgery.
abstract: METHODS
  Prospective observational study.
  
  
  OBJECTIVE
  To assess patient quality of life before and after surgical treatment of adolescent idiopathic scoliosis (AIS) and determine whether an association exists between quality of life and curve magnitude, curve correction, and type of instrumentation.
  
  
  BACKGROUND
  Assessment of AIS surgery outcomes has always been based on analysis of radiographic measurements and postoperative curve correction. However, there is a current trend toward greater emphasis on patient-centered outcomes. Assessment of treatment success on the basis of these outcomes requires prospective use of quality-of-life surveys before and after AIS treatment.
  
  
  METHODS
  Prospective study of 33 patients undergoing surgical treatment of AIS. Mean age was 15.6 years and mean Cobb angle was 70.5 degrees. Patients were randomly allocated into one of 2 instrumentation groups (hybrid and pedicle screws alone), and the Scoliosis Research Society-30 questionnaire (SRS-30) and Short Form-36 Health Survey (SF-36) questionnaires were administered preoperatively and at 3-, 6-, and 12-month follow-up. Statistical testing was performed to determine whether survey scores correlated with Cobb angle, curve correction, or type of instrumentation.
  
  
  RESULTS
  SRS-30 and SF-36 scores improved significantly. The greatest changes occurred in the self-image and satisfaction with management domains of the SRS-30 survey. SRS-30 and SF-36 scores showed worsening pain and decreased function at 3-month follow-up, but significant improvement from baseline at 12 months. Total SRS-30 scores were significantly improved at 6- and 12-month follow-up, as were subscores in the general health, vitality, and social functioning domains of SF-36. Curve magnitude, percent curve correction, and type of instrumentation had no significant influence on final SRS-30 and SF-36 scores.
  
  
  CONCLUSIONS
  Surgical treatment of AIS improved patient quality of life, as shown by significant improvement on all SRS-30 and SF-36 domains. Questionnaire scores did not correlate with Cobb angle, curve correction, or type of instrumentation.
authors.affiliation: Department of Orthopedics and Traumatology, Division of Spine Surgery, Santa Casa de São Paulo, Brazil.
authors.forename: Luciano N
authors.initials: LN
authors.lastname: Pellegrino
authors.forename: Osmar
authors.initials: O
authors.lastname: Avanzi
mesh_terms: D000293:Adolescent; D001863:Bone Screws; D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D011788:Quality of Life; D011859:Radiography; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000523:psychology* / Q000601:surgery*; D012919:Social Behavior; D016896:Treatment Outcome; D055815:Young Adult