Cross-Cultural Comparison of the SRS Outcomes Instrument between American and Japanese Scoliosis Patients: Are there Differences?
Methods: We analyzed two comparable groups of 100 preoperative idiopathic scoliosis patients, which were separated into American (Group A) and Japanese (Group J) populations prior to spinal fusion. There were no statistically significant differences between the groups for: gender (A: 9 male, 91 female vs. J: 13 male, 87 female), age (A: 15.0±2.4 vs. J: 14.9±3.8), main curve location, main curve Cobb angle, and thoracic kyphosis (p>0.05 for all comparisons). The patients were evaluated using the first section (15 questions) of the SRS-24, which was divided into four domains: total pain, general self-image, general function, and activity. Statistical comparison was performed using the Mann Whitney U test.
Results: See Table) Group A had significantly lower scores in pain (p<0 .0001, A: 3.7±0.8 vs. J: 4.3±0.4), function (p<0.01, 3.9±0.6 4.2±0.5) and activity (p<0.0001, A; 4.5±0.8 J; 4.9±0.3) domains compared to Group J. J had significantly lower scores in the self-image 4.0±0.7 3.5±0.5) domain. With regard individual questions, there were significant differences for all questions except question five 13 between two groups.
Conclusion: There were significant differences in all four domains between American and Japanese scoliosis patients. Japanese patients had less pain, a more negative self-image with higher general function and daily activity. It is highly probable that different culturally related perceptions of the patient affect the SRS-24 scores so a cross-cultural comparison of the SRS-instrument is necessary.