What Kinds of Cosmetic Appearances were Improved after Scoliosis Surgery in Adolescent Idiopathic Patients? A Longitudinal Long-term Postoperative 7-year Study Using Spinal Appearance Questionnaire

Abstract

appearance questionnaire (SAQ) are well-known scoliosis-specific questionnaires both aiming for the health issues related to idiopathic scoliosis. 4 Spinal Appearance Questionnaire was modified by Sanders et al. from the Walter Reed Visual Assessment Scale to access a patient's perception of several aspects of the spinal deformity based on a pictorial scale. [5][6][7][8] Spinal appearance questionnaire was proved to be reliable, valid, and responsive. [5][6][7] Long-term follow-up of patients' perceptions of their cosmetic appearance has not yet been discussed. The shoulder balance of AIS patients who underwent surgery was changed from left down to left up [reflected by the changes in T1 Tilt IntroductIonAdolescent idiopathic scoliosis (AIS) is a three-dimensional deformity presenting with back deformity, a rib hump, and/or shoulder asymmetry. 1 Adolescent idiopathic scoliosis patients of major Cobb angle ≥60° require spinal surgical correction. The primary purpose of spinal corrective surgery is to prevent scoliosis progression by achieving a spinal fusion of the regions of the spine that are involved in the curve. 2 On patients' perspective, they would like to see their trunk or cosmetic appearances improved after surgery. These kinds of "outlook improvements" are hugely concerned by surgical patients, although no specific and objective discussion evaluating their long-term changes in appearances after surgery has been reported. "Appearance" or similar terms might appear in different questionnaires, these tools are non-appearance specific which lacks a comprehensive reflection of cosmetic appearance from patients who underwent spinal correction surgery, even though the questionnaires are scoliosis-specific.The number of studies on health-related quality of life (HRQOL) of surgical AIS patients after surgery has been increasing due to the increase in patient's awareness of their well-being after surgery, as a result of the popularity of social media. This leads to the development of different kinds of patient-reported outcome questionnaires or tools, of which some of them are diseasespecific and some of them are for a non-specific purpose (e.g., Short Form-36 3 ).