Scoliosis Research Society-22 Patient Questionnaire Responsiveness to Change Associated with Surgical Treatment: Preliminary Results

· (c - Depuy Acromed) University of Kansas Medical Center, Kansas City, Kansas, USA

The SRS-22 questionnaire is a disease specific instrument developed to assess the effect of idiopathic scoliosis on the patient from their vantage point. The purpose of this study is to determine the responsiveness of the SRS-22 questionnaire to patient change associated with surgery.

METHODS: This is an ongoing prospective study. To date 49 patients (42F, 7M) average age 16.6 years (range, 10.6 to 47.3) with average Cobb size 63° (range, 42° to 137°) have been enrolled. Patients are tested pre operatively and at 3, 6, and 12 months intervals post operatively utilizing the SRS-22 outcomes questionnaire. The questionnaire consists of 5 domains: pain; self-image; function; mental health; and satisfaction with management. There are five questions in the first four domains and two in the last, the scoring scale being 5 best and 1 lowest. Statistical analysis is done using the paired t-test. Statistical significance was p=0.01. Statistical significance is calculated only on individuals with domain scores available at given two time points of interest: 3 months, n=34; 6 months, n=23; and 12 months, n=21.

RESULTS: Self image was significantly improved at three months and remained improved: Pre operative 3.3; 3 months 4.3 (p ‹ 0.0001); 6 months 4.3 (p=0.0003); and 12 months 4.3 (p ‹ 0.0001). Self image also significantly improved from 3 to 12 months (p=0.01). Function was significantly decreased at 3 months but returned to baseline at 6 and 12 months: pre operative 4.0; 3 months 3.2 (p=0.0001); 6 months 3.8 (ns) and 12 months 4.3 (ns). The improvement from 3 to 6 months was significant (p=0.0007). Pain did not show significant change: preoperatively 3.9; 3 months 3.5; 6 months 3.8; and 12 months 4.1 but did show a significant improvement from the 3 to 12 month post operative period (p=0.002). Mental health was not significantly affected. The subtotal score combining the self image, function, pain, and mental health domains was significantly improved at 12 months; pre operative 3.8; 3 months 3.8 (ns); 6 months 4.0 (ns); and 12 months 4.3 (p=0.004).

CONCLUSION: The SRS-22 questionnaire is responsive to changes in the post surgical period. The changes observed are concordant with those expected clinically except that the self image improvement occurred earlier than anticipated and, at three months, the pain change did not reflect the substantial post operative pain.