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Abstract from the SRS 2001 Annual Meeting
Marc Asher, MD
Sue Min Lai, Ph.D.
Doug Burton, MD
Barbara Manna, RN · (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.
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