title: Minimum 20 Years Long-term Clinical Outcome After Spinal Fusion and Instrumentation for Scoliosis: Comparison of the SRS-22 Patient Questionnaire With That in Nonscoliosis Group.
abstract: METHODS
  A retrospective minimum 20-year follow-up study using 4 standard self-administered questionnaires, one of which, the SRS-22 was also administered to control groups.
  
  
  OBJECTIVE
  To evaluate long-term postoperative pain and other clinical outcomes of scoliosis correction and fusion surgery with Harrington instrumentation using Moe square-ended rods for better preservation of sagittal alignment.
  
  
  BACKGROUND
  Only a few long-term outcome studies have used standardized and validated self-administered tools, and no studies have established SRS-22 control data within their own population. There is no previous minimum 20-year follow-up evaluation after correction surgery preserving thoracic kyphosis and lumbar lordosis.
  
  
  METHODS
  Of 86 consecutive patients who underwent instrumentation surgery for scoliosis by a single surgeon, 61 patients participated using Japanese Orthopaedic Association, Roland-Morris Disability Questionnaire, Oswestry Disability Index, and Scoliosis Research Society (SRS-22) questionnaires and 51 patients were included in this study. Results were analyzed for pain and other clinical outcomes. A total of 771 hospital employees were sent SRS-22 questionnaires. A total of 763 responded, resulting in 2 control groups composed of nonscoliosis and untreated mild scoliosis controls of the same culture and language as the long-term follow-up group.
  
  
  RESULTS
  The prevalence of continuous low back pain was about 15%. Average Japanese Orthopaedic Association, Oswestry Disability Index, and Roland-Morris Disability Questionnaire scores at follow-up were 25 points, 7.3%, and 1.6, respectively. The average SRS-22 scores were 4.2 (function), 4.3 (pain), 3.7 (self-image), and 3.9 (mental health) for the postoperative follow-up group compared with 4.5 (function), 4.3 (pain), 3.5 (self-image), and 3.5 (mental health) for the nonscoliosis controls.
  
  
  CONCLUSIONS
  Improved preservation of normal sagittal alignment resulted in a prevalence of low back pain comparable with the age-matched general population. Moreover, SRS-22 results for self-image and mental health were positive compared with the controls, possibly reflecting the surgeon's emphases on mental health and management of patient expectations.
  
  
  METHODS
  4.
authors.affiliation: *Department of Orthopaedic Surgery, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan †Scoliosis Center, Saiseikai Central Hospital, Tokyo, Japan ‡Department of Orthopaedic Surgery, Saiseikai Kanagawa-ken Hospital, Yokohama, Japan; and §Department of Orthopaedic Surgery, Dokkyo Medical University, Mibu-machi, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Iida
authors.forename: Nobumasa
authors.initials: N
authors.lastname: Suzuki
authors.forename: Katsuki
authors.initials: K
authors.lastname: Kono
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Ohyama
authors.forename: Jyunya
authors.initials: J
authors.lastname: Imura
authors.forename: Akihisa
authors.initials: A
authors.lastname: Ato
authors.forename: Satoru
authors.initials: S
authors.lastname: Ozeki
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nohara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000209:etiology*; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D012600:Scoliosis / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D012649:Self Concept; D013123:Spinal Fusion / Q000009:adverse effects / Q000295:instrumentation*; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult