Health Assessment in Adult Scoliosis Patients Using the Short Form 36

Maimonides Medical Center, Brooklyn, New York, USA

INTRODUCTION:
The SF-36 Health Survey is recognized as a reliable measure of patient self-assessment. Despite widespread use in a number of medical areas and conditions, this survey has been used to assess an adult scoliosis population. It is thought that adult patients with scoliotic deformities view their overall health as being poor compared to the general U.S. population. This study set out to test the accuracy of this belief, as well as compare the scores of scoliosis patients to the scores of patients with comorbid conditions: back pain/sciatica with hypertension, using the SF-36 Health Survey.

METHODS:
This is a consecutive review of adult patients presenting with scoliosis seen in clinical practice over a two-year period. Inclusion criteria were: age > 18 years, lateral deviation of the spine greater than 10 degrees, degenerative or idiopathic deformity, no prior surgery (spine), complete records. Each patient completed the 36-item short form survey to the best of his/her ability. The survey is divided into 8 categories, and provides a separate score for each item: Physical Functioning, Role Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role Emotional, and Mental Health.

RESULTS:
The study included 49 patients (16 males, 33 females) average age 64 (range 18-87). Using the scoring algorithms and data entry criteria set forth by the SF-36 Health Survey Manual, individual patient scores were calculated. The means for each category were as follows: PF=51, RP=30, BP=33, GH=59, VT=42, SF=51, RE=44, and MH=61. The results fell within the precision guidelines set forth by the SF-36 guidelines for accurate comparison. In comparison to established US population means and patients with back pain/sciatica (and hypertension), statistically lower SF-36 scores in all categories were noted for the study group (p<0.05).

CONCLUSION:
Adult scoliosis significantly impacts self-assessed health. In this study group SF-36 scores were significantly lower than the norms for the general U.S. population in all 8 categories, and lower than the norms for aged matched patients suffering from back pain/sciatica with hypertension. This reveals a significant health impact of adult scoliosis. Further investigation and efforts directed at quality of life issues and treatment of adult scoliosis are necessary.