Comparison of SRS Questionnaire Results Submitted by Both Parents and Patients in the Operative Treatment of Idiopathic Scoliosis

Background: No report to our knowledge address the validity of parent assessments of their child’s pre- and post-surgical outcome as verified by SRS-24 questionnaire data, even though parents often provide the majority of verbal feedback to the surgeon at office visits. We performed a prospective analysis of patients with operative idiopathic scoliosis (IS) to compare SRS-24 scores from both parents and patients obtained separately on the same day of the office visit. Scores were analyzed emphasizing parent-patient disparities in the preop, early postop and late postop periods.

Materials and Methods: 101 patients with operative IS were analyzed based upon paired parent/patient SRS-24 data and radiographs performed on the same day. Patients were categorized by age at date of exam (9-23 yrs, mean 17+5 yrs.), gender (16M, 85F), major curve magnitude (41–126 deg), procedure type [preop (23 pairs), ASF (48 pr.), ASF/PSF (19 pr.), PSF (46 pr.)], and time from surgery (preop, 1–93 mos., mean 24 mos.). All questionnaire scores were classified based on domains of pain, self-image (SI), function (Funct.), overall satisfaction (Satis.), and total score (TS).

Results: When comparing parents and patients over all time periods, parents consistently scored higher than their children in SI (score difference 4.65±9.98, p=0.0001), Satis. (diff. 3.67±10.40, p=0.0001), and TS (diff. 0.98±6.27, p=0.004), but not pain or Funct. In terms of patient age and SRS scores, there was a significant correlation between Satis. differences (3.67±10.40, p=0.04), but not other domains. There were no significant differences with gender or preop/postop major curve magnitudes. Parents were more satisfied than patients when the patient received a PSF (diff. 6.31±11.89, p=0.002), but had similar Satis. after an ASF. When comparing postop time to SRS scores, there was a trend between differences in TS (r=-0.15, p<0.09) and Satis. (r=-0.18, p=0.07), but not other domains.

Discussion: Based on SRS-24 data, parents typically scored higher than their children in the operative treatment of IS in total score, self-image and overall satisfaction. Parent-patient scores correlated better with increasing age of the patient, and later in the post-op period.