Effect of spinal deformity on adolescent quality of life: comparison of operative scheuermann kyphosis, adolescent idiopathic scoliosis, and normal controls.
METHODS
A prospective multicenter study and retrospective chart review.


OBJECTIVE
To compare health-related quality of life (HRQOL) measures and sagittal deformity in operative Scheuermann kyphosis (SK), operative adolescent idiopathic scoliosis (AIS), and normal populations.


BACKGROUND
No study to date has evaluated patient reported HRQOL measures before surgery in operative patients with SK.


METHODS
HRQOL data were prospectively collected pretreatment for operative patients with SK using the SRS-22 outcomes instrument and visual analogue scale (VAS). Comparison was made with the SRS-22 from operative AIS and normal populations. Eighty-six patients with SK enrolled in the prospective study were compared with 184 patients with AIS from a prospective database and 31 normal controls. To study the correlation between T5-T12 kyphosis magnitude and SRS-22 score, patients with AIS and SK were pooled together to create a larger continuum of kyphosis. Analysis of covariance, Pearson correlation analysis, and Bonferroni pairwise comparisons were used to determine statistical differences between group demographics, HRQOL indicators, and radiographical variables.


RESULTS
Patients with SK had significantly lower scores in all domains of the SRS-22 than patients with AIS. Patients with SK with a thoracolumbar apex reported significantly lower mean scores in the pain domain than those with a thoracic apex. Significant negative correlations were found between all domains of the SRS-22 and T5-T12 kyphosis-the self-image domain demonstrated the highest correlation (r = 0.37). VAS score in the SK population correlated negatively to the pain, self-image, and mental health domains.


CONCLUSIONS
Increasing sagittal plane deformity as a result of SK has a significant impact on HRQOL as determined by the SRS-22 outcome instrument. In this study, patients with SK reported significantly decreased (worse) scores in all subdomains of the SRS-22 compared with patients with AIS.


METHODS
1.
*Hospital for Joint Diseases-NYU Medical Center, New York, NY †Johns Hopkins Hospital, Baltimore, MD ‡Shriners Hospital for Children, Philadelphia, PA §Miami Children's Hospital, Miami, FL ¶Nemours Children's Clinic, Wilmington, DE; and ‖Rady Children's Hospital, San Diego, CA.
Baron
B
Lonner
Andrew
A
Yoo
Jamie S
JS
Terran
Paul
P
Sponseller
Amer
A
Samdani
Randy
R
Betz
Harry
H
Shuffelbarger
Suken A
SA
Shah
Peter
P
Newton
D000203:Activities of Daily Living; D000293:Adolescent; D000294:Adolescent Behavior; D001416:Back Pain / Q000175:diagnosis / Q000523:psychology; D001828:Body Image; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D012189:Retrospective Studies; D012544:Scheuermann Disease / Q000145:classification / Q000175:diagnosis / Q000523:psychology*; D012600:Scoliosis / Q000145:classification / Q000175:diagnosis / Q000523:psychology*; D012649:Self Concept; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult