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Reliability and validity of a kyphosis-specific spinal appearance questionnaire

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Abstract

Purpose

Hyperkyphosis, including Scheuermann and postural kyphosis, is associated with decreased perceived cosmesis and well being. No patient reported outcome questionnaire specific to kyphosis exists. We sought to assess the internal consistency, test–retest reliability and concurrent validity of a new Kyphosis-specific Spinal Appearance Questionnaire (K-SAQ).

Methods

A K-SAQ was developed from a modified SAQ to measure kyphosis-specific aspects of appearance. Patients with hyperkyphosis (ages 10–20 years) curves ≥ 50° completed the K-SAQ and SRS-22R at baseline and the K-SAQ 2 weeks later.

Results

55 patients completed the K-SAQ and SRS-22R. 28 patients completed the K-SAQ 2 weeks later. The K-SAQ total averages showed excellent internal consistency (Cronbach’s α = 0.91) and test–retest reliability (ICC = 0.84). Moderate associations were seen between the SRS-22R subtotal average score and K-SAQ total average score and (r = − 0.62, p < 0.001) and the SRS-22R self-image domain with the K-SAQ total average score (r = − 0.57, p < 0.001). Higher BMI and increased age scored worse on the K-SAQ total average, whereas only higher BMI scored worse on the SRS-22R subtotal average.

Conclusion

The K-SAQ is a reliable patient reported outcome measure of kyphosis-specific aspects of appearance.

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References

  1. Tribus CB (1998) Scheuermann’s kyphosis in adolescents and adults: diagnosis and management. J Am AcadOrthopSurg 6:36–43

    CAS  Google Scholar 

  2. Lonner B, Yoo A, Terran JS et al (2013) Effect of spinal deformity on adolescent quality of life comparison of operative Scheuermann’s Kyphosis, Adolescent Idiopathic Scoliosis and Normal Controls. Spine (Phila Pa 1976) 38(12):1049–1055

    Article  Google Scholar 

  3. Petcharaporn M, Pawelek J, Bastrom T, Lonner B, Newton PO (2007) The relationship between thoracic hyperkyphosis and the Scoliosis Research Society outcomes instrument. Spine (Phila Pa 1976) 32(20):2226–2231

    Article  Google Scholar 

  4. Ristolainen L, Kettunen JA, Heliövaara M, Kujala UM, Heinonen A, Schlenzka D (2012) Untreated Scheuermann’s disease: a 37-year follow-up study. Eur Spine J. 21(5):819–824

    Article  CAS  Google Scholar 

  5. Polly DW, Ledonio CGT, Diamond B et al (2019) What are the indications for spinal fusion surgery in Scheuermann kyphosis? J PediatrOrthop 39:217–221

    Google Scholar 

  6. Toombs C, Lonner B, Shah S et al (2018) Quality of life improvement following surgery in adolescent spinal deformity patients: a comparison between scheuermann kyphosis and adolescent idiopathic scoliosis*. Spine Deform 6(6):676–683

    Article  Google Scholar 

  7. Sanders JO, Harrast JJ, Kuklo TR et al (2007) The Spinal Appearance Questionnaire: results of reliability, validity, and responsiveness testing in patients with idiopathic scoliosis. Spine (Phila Pa 1976) 32(24):2719–2722

    Article  Google Scholar 

  8. Mulcahey MJ, Chafetz RS, Santangelo AM et al (2011) Cognitive testing of the spinal appearance questionnaire with typically developing youth and youth with idiopathic scoliosis. J PediatrOrthop 31(6):661–667

    Google Scholar 

  9. Carreon LY, Sanders JO, Polly DW et al (2011) Spinal appearance questionnaire: factor analysis, scoring, reliability, and validity testing. Spine (Phila Pa 1976) 36(18):E1240–E1244

    Article  Google Scholar 

  10. Carreon LY, Sanders JO, Diab M, Polly DW, Diamond BE, Sucato DJ (2013) Discriminative properties of the spinal appearance questionnaire compared with the scoliosis research Society–22 revised. Spine Deform 1(5):328–338

    Article  Google Scholar 

  11. Asher M, Min Lai S, Burton D, Manna B (2003) The reliability and concurrent validity of the scoliosis research society-22 patient questionnaire for idiopathic scoliosis. Spine (Phila Pa 1976) 28(1):63–69

    Article  Google Scholar 

  12. Asher MA, Lai SM, Glattes RC, Burton DC, Alanay A, Bago J (2006) Refinement of the SRS-22 health-related quality of life questionnaire function domain. Spine (Phila Pa 1976) 31(5):593–597

    Article  Google Scholar 

  13. O’Connor BP (2000) SPSS and SAS programs for determining the number of components using parallel analysis and Velicer’s MAP test. Behav Res Methods InstrumComput 32(3):396–402

    Article  Google Scholar 

  14. Chen J, Ou L, Hollis SJ (2013) A systematic review of the impact of routine collection of patient reported outcome measures on patients, providers and health organisations in an oncologic setting. BMC Health Serv Res 13(1):1

    Article  Google Scholar 

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Acknowledgements

The authors would like to acknowledge Anna McClung for assistance developing the K-SAQ.

Funding

No funding was received for this work.

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Authors and Affiliations

  1. Therapy Services, Scottish Rite for Children, 2222 Welborn Street, Dallas, TX, 75219, USA

    Karina A Zapata, ChanHee Jo & Charles E. Johnston

  2. Norton Healthcare, Louisville, KY, USA

    Leah Y. Carreon

Authors
  1. Karina A Zapata
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  2. ChanHee Jo
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  3. Leah Y. Carreon
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  4. Charles E. Johnston
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Contributions

KZ made substantial contributions to the conception and design of the work and data acquisition, KZ drafted the work and revised the work, approved the version to be published, agree to be accountable for all aspects of the work. CJ made substantial contributions to the design of the study and to analysis of the data, CJ revised the work critically for important intellectual content, approved the version to be published, agree to be accountable for all aspects of the work. LC made substantial contributions to data interpretation, LC revised the work critically for important intellectual content, approved the version to be published, agree to be accountable for all aspects of the work. CEJ made substantial contributions to the conception of the work, CEJ revised the work critically for important intellectual content, approved the version to be published, agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Karina A Zapata.

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Conflict of interest

Leah Carreon is an employee of Norton Healthcare and University of Southern Denmark; consulting fees from National Spine Health Foundation; member, Editorial Advisory Board, Spine Deformity, The Spine Journal and Spine; member University of Louisville IRB. Institution received research funds from OREF, NIH, ISSG, SRS, TSRH, Pfizer, Lifesciences Corporation, IntelliRod, Cerapedics, Medtronic, Empirical Spine and NeuroPoint Alliance. Charles Johnston: Medtronic, royalties and research support; Elsevier, royalties.

Ethical approval

IRB approval was received from Scottish Rite for Children and from University of Texas Southwestern.

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Zapata, K.A., Jo, C., Carreon, L.Y. et al. Reliability and validity of a kyphosis-specific spinal appearance questionnaire. Spine Deform 9, 933–939 (2021). https://doi.org/10.1007/s43390-021-00292-9

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  • DOI: https://doi.org/10.1007/s43390-021-00292-9

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