Long-Term Evaluation of the Quality of Life of Subjects with Adolescent Idiopathic Scoliosis (AIS)

Introduction: Quality of life (QOL) is a new concept based on notions such as satisfaction, emotional state, personal achievements and working abilities. Up to now, there are not many studies which evaluate the quality of life for patients with adolescent idiopathic scoliosis (AIS). The purpose of this study was to compare adulthood quality of life for patients with or without surgery after AIS.

Materials and Methods: The study was designed as a comparative retrospective cohort study. Subjects referred for Adolescent Idiopathic Scoliosis between 1960 and 1979 to Sainte-Justine Hospital were entered into the cohort. Inclusion criteria were being operated or not for AIS and having a Cobb angle >35° at the last visit.

A self-administered questionnaire was sent to all eligible patients. The questionnaires that were used were all reliable and valid. More specifically, the instruments used were the Oswestry, Roland, SF-36, Quebec Back Pain Disability Scale, Scoliosis Research Society and the EuroQol-5D.

Results: Among the 299 AIS subjects responding, 204 had surgery and 95 none and their mean Cobb angle was respectively 58 and 44 degrees. All patients had a follow-up more than 20 years. There were significantly no difference as for sex, life status, education, working areas, alcoholism, smoking habits, chronic illness and reproductive health between the two groups. Same proportion of subjects in both group (~30%) had no back pain; but more non-operated subjects had = physiotherapy and/or chiropractic treatments (p< 0.001). The mean Rolland score for subjects was significantly higher for the group who had surgery (p=0.02). Using multiple regression analysis, the only variable affecting physical component of the quality of life measured with the SF-36 was the alcohol consumption whereas the psychological of the SF-36 was predicted by alcohol consumption as well and the gender. The quality of life measured by the EuroQol was predicted mainly by the marital status, people being married having a better score.

Conclusion: Overall, there is not significant difference in the for quality of life in adulthood between the subjects with AIS whether they had surgery or not. Subjects who had surgery tend to be less in pain than people not operated on.