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Body Image Disturbance Improvement After Operative Correction of Adolescent Idiopathic Scoliosis

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Abstract

Hypothesis

Body Image Disturbance Questionnaire–Scoliosis version (BIDQ-S) is a sensitive outcomes instrument to evaluate improvements in body image–related psychosocial effects with surgical correction.

Design

Prospective observational study.

Introduction

The BIDQ-S was previously validated (convergent validity, internal consistency) as a tool to assess body image–related distress and psychosocial impairment in adolescent idiopathic scoliosis (AIS). This study was conducted to evaluate responsiveness to change in the BIDQ-S associated with surgical treatment of AIS two years postoperatively to complete the validation of this questionnaire.

Methods

Seventy-five consecutive operative AIS patients were enrolled and completed BIDQ-S and Scoliosis Research Society–22 (SRS-22) at preoperative and two-year postoperative visits. Demographic and radiographic data were collected. Preoperative and two-year postoperative BIDQ-S (1 = best, 5 = worst) and SRS-22 scores (1 = worst, 5 = best) were compared using paired t test. Correlations between BIDQ-S and SRS-22 scores were evaluated by linear regression.

Results

Eighty-four percent of the subjects were females, with average age at surgery of 14.4 ± 1.6 years. The mean follow-up was 2.26 years (range 2.0-4.5). The major Cobb was corrected from 50.0° ± 7.2° to 14.2° ± 5.8° (Δ = 71.3% ± 12.1%; p < .0001). There was a significant improvement in BIDQ-S scores after surgery (1.64 ± 0.51 to 1.21 ± 0.38, p < .0001). BIDQ-S improvements were correlated with change in SRS self-image (p = .0055), activity (p = .0057), mental (p = .0018), and overall mean (p = .0007) domains. Preoperative, two-year postoperative, and Δ BIDQ-S score were not associated with major Cobb magnitude, truncal rotation, or Lenke curve type. Patients who reached SRS-22r minimal clinically important difference (MCID) in activity and self-image domains had worse preoperative BIDQ scores than those who did not reach MCID (activity 1.91 vs. 1.54 [1 = best, 5 = worst], p = .0099; self-image 2.08 vs. 1.51, p < .0001). Greater improvement in BIDQ-S was noted in patients who reached MCID in SRS-22 self-image than those who did not (Δ = 0.77 vs. 0.38, p = .0052).

Conclusion

BIDQ-S is responsive to surgical correction of AIS. The BIDQ-S is a valuable clinical outcome tool to assess the psychosocial effects of scoliosis in adolescents augmenting existing outcome instruments.

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Authors and Affiliations

  1. Mount Sinai Hospital, 1 Gustave L. Levy Place, 10029-6574, New York, NY, USA

    Baron S. Lonner MD, Robert Brochin MD, Khushdeep S. Vig BA, Gabrielle Kassin BS, Andrea Castillo BS & Yuan Ren PhD

  2. New York University, 10003, New York, NY, USA

    Roxanne Lewis BS

Authors
  1. Baron S. Lonner MD
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  2. Robert Brochin MD
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  3. Roxanne Lewis BS
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  4. Khushdeep S. Vig BA
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  5. Gabrielle Kassin BS
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  6. Andrea Castillo BS
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  7. Yuan Ren PhD
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Corresponding author

Correspondence to Baron S. Lonner MD.

Additional information

Author disclosures: BSL (grants from Setting Scoliosis Straight Foundation; personal fees from DePuy Synthes Spine, K2M, Paradigm Spine, Spine Search, and Ethicon; nonfinancial support from Spine Deformity Journal; grants from John and Marcella Fox Fund Grant and OREF; personal fees from Zimmer Biomet, Apifix, and Unyq, outside the submitted work), RB (none), RL (none), KSV (none), GK (none), AC (none), YR (none).

Funding: No Research funding was received.

IRB Approval: This study was reviewed and approved by Mount Sinai Hospital Institutional Review Board.

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Lonner, B.S., Brochin, R., Lewis, R. et al. Body Image Disturbance Improvement After Operative Correction of Adolescent Idiopathic Scoliosis. Spine Deform 7, 741–745 (2019). https://doi.org/10.1016/j.jspd.2018.12.005

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  • DOI: https://doi.org/10.1016/j.jspd.2018.12.005

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