APSS-ASJ Best Clinical Research Award: Is There a Difference between Patients’ and Parents’ Perception of Physical Appearance in Adolescent Idiopathic Scoliosis?

Abstract

Study Design Prospective study. Purpose To compare patients’ and parents’ perceptions of physical attributes (PAs) of adolescent idiopathic scoliosis (AIS) patients and to report any correlations between their perceptions and Scoliosis Research Society-22r (SRS-22r) scores. Overview of Literature Few studies have looked into the differences between patients’ and parents’ perceptions of their appearance. Methods AIS patient–parent pairs (n=170) were recruited. The patients’ and parents’ perceptions of six PAs were evaluated: waist asymmetry (WA), rib hump (RH), shoulder asymmetry (SA), neck tilt, breast asymmetry (BrA), and chest prominence. These PAs were ranked, and an aggregate PA (Agg-PA) score was derived from a score assigned to the attribute (6 for the most important PA and 1 for the least important). The patients also completed the SRS-22r questionnaire. Results Ninety-nine patients (58.2%) and 71 patients (41.8%) had thoracic and lumbar major curves, respectively. WA was ranked first by 54 patients (31.8%) and 50 parents (29.4%), whereas RH was ranked first by 50 patients (29.4%) and 38 parents (22.4%). The overall Agg-PA scores were similar for patients and parents ( p >0.05). However, for thoracic major curves (TMCs) >40°, a significant difference was noted between the Agg-PA scores of patients and parents for SA (3.5±1.6 vs. 4.2±1.6, p =0.041) and BrA (3.0±1.6 vs. 2.2±1.3, p =0.006). For TMCs <40°, a significant difference was found between the Agg-PA scores of patients and parents for WA (3.7±1.6 vs. 4.4±1.5, p =0.050). BrA was negatively correlated with total SRS-22r score. Conclusions There were no significant differences between patients and parents in their ranking of the most important PAs. For TMCs >40°, there were significant differences in the Agg-PA for SA and BrA. Pa¬tients were more concerned about BrA and parents were more concerned about SA. Patients’ perception of the six PAs had weak correlation with SRS-22r scores.

Patients’ Perception and Satisfaction on Neck and Shoulder Imbalance in Adolescent Idiopathic Scoliosis

“…[6][7][8] Surgeons' primary aim had always been correcting the coronal curvature. However, PSI became a concern as patients' perspective on their postoperative appearances including shoulder balance was found to be imperative in determining the cosmetic outcomes of the surgery [8][9][10][11][12][13][14][15][16][17][18][19][20][21]22 The focus of surgical concern was then shifted to achieve a balanced postoperative shoulder instead. Various methods were introduced to circumvent PSI such as upper thoracic spine leveling, upper instrumented vertebra (UIV) level selection, UIV tilt angle, fusion level selection, preoperative shoulder balance, proximal thoracic (PT) correction rate and its extent of correction of main thoracic (MT) curve.…”

“…Most of the studies listed spinal deformity aspects such as body curves, rib prominence and shoulder balance as factors taken into account of the patients' perception and satisfaction. [18][19][20][21] However, patients' perception of neck imbalance was not reported. Hence, the purpose of this study was to determine the perception and satisfaction among preoperative/ postoperative AIS patients with regard to Neck Tilt with Medial Shoulder Imbalance (NT) as compared to Lateral Shoulder Imbalance (LSI), and its influence on patients' Health Related Quality of Life (HRQoL).…”

Clinical outcomes of selective fusion for the thoracolumbar-lumbar curve in patients with Lenke type 6C adolescent idiopathic scoliosis: a preliminary study

“…Such a physical appearance is reportedly responsible for the psychological distress of the patient proportionate to its severity [19,20]. Among these physical appearances, trunk or waist asymmetry is highly subjective and plays the most important role in the patient's overall perception of their deformity [21,22]. Qiu et al [23] reported that the lumbar or thoracolumbar AVT best reflects cosmesis of the trunk in Lenke type 5 and 6 AIS.…”