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Patient-Reported SRS-24 Outcomes Scores After Surgery for Adolescent Idiopathic Scoliosis Have Improved Since the New Millennium

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Abstract

Study Design

Observational.

Objective

To examine changes in patient-reported two-year postoperative outcomes via the Scoliosis Research Society (SRS)-24 Outcomes Instrument from 2001 through 2015.

Summary of Background Data

Techniques for correction of adolescent idiopathic scoliosis (AIS) have evolved over the years, but it is unclear how these changes have impacted patient-reported outcomes.

Methods

AIS patients with two-year postoperative follow-up from a prospective multicenter registry were divided into three-year groups based on trends in surgical approach and construct type (2010–2014: 52% anterior, 43% posterior hybrids; 2005–2011: 3% anterior, 5% posterior hybrids; 2012–2015: 0% anterior, 0.2% posterior hybrids). Because of the ordinal scale (1-5) and bipolar nature of the response sets for the SRS-24, domain/total scores were categorized as ≤3 (predominantly negative) or 4–5 (predominantly positive). Variables were compared across the three groups.

Results

A total of 1,695 patients were analyzed; 172 (2010–2014), 926 (2005–2011), and 597 (2012–2015). Average age was 14.7 ± 2 years, the average primary curve was 55° ± 13°, and the group was primarily female (82%). There was a decline in the rate of positive scores for preoperative pain and self-image across the three groups (p < .05). There was an increase in the rate of positive scores for two-year postoperative self-image after surgery, function after surgery, and satisfaction (p < .05). Decreases in length of hospital stay, blood loss, surgical time, preoperative kyphosis, and postoperative trunk shift were observed (p < .05). Increases were observed in levels fused, preoperative major coronal curve, preoperative rib prominence, preoperative trunk shift, percentage correction of major curve, kyphosis restoration, and the rate of double/triple curves (p < .05).

Conclusion

The percentage of patients with positive postoperative SRS scores has increased in the modern era, providing evidence that newer surgical techniques are resulting in improved outcomes based on the patients’ perspectives. Interestingly, recent patients were more afflicted with negative pain and self-image before surgery.

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Author information

Authors and Affiliations

  1. Rady Children’s Hospital, 3020 Children’s Way, San Diego, CA, 92123, USA

    Tracey P. Bastrom MA, Carrie E. Bartley MA & Peter O. Newton MD

  2. Chief Division of Orthopedics, Department of Orthopedic Surgery, Rady Children’s Hospital, University of California, San Diego, 3030 Children’s Way, MC5062, San Diego, CA, 92123, USA

    Peter O. Newton MD

Authors
  1. Tracey P. Bastrom MA
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  2. Carrie E. Bartley MA
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  3. Peter O. Newton MD
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Consortia

Harms Study Group

Corresponding author

Correspondence to Peter O. Newton MD.

Additional information

Author disclosures: TPB (grants from Setting Scoliosis Straight Foundation, during the conduct of the study), CEB (grants from Setting Scoliosis Straight Foundation, during the conduct of the study), PON (grants from Setting Scoliosis Straight Foundation, during the conduct of the study; grants and other from Setting Scoliosis Straight Foundation and Scoliosis Research Society [SRS]; other from Rady Children’s Specialists; grants, personal fees, and nonfinancial support from DePuy Synthes Spine and K2M; grants from EOS Imaging and NuVasive; personal fees from Thieme Publishing and Cubist; other from Electrocore; other from International Pediatric Orthopedic Think Tank; grants, nonfinancial support, and other from Orthopediatrics; grants and nonfinancial support from Alphatech; grants from Mazor Robotics, outside the submitted work; in addition, PON has a patent “Anchoring Systems and Methods for Correcting Spinal Deformities” (8540754) with royalties paid to DePuy Synthes Spine; a patent “Low Profile Spinal Tethering Systems” (8123749) licensed to DePuy Spine, Inc.; a patent “Screw Placement Guide” (7981117) licensed to DePuy Spine, Inc.; a patent “Compressor for Use in Minimally Invasive Surgery” (7189244) licensed to DePuy Spine, Inc.; and a patent “Posterior Spinal Fixation” pending to K2M), Harms Study Group (grants from DePuy Synthes Spine and EOS Imaging, during the conduct of the study; grants from NuVasive, K2M, Inc., Medtronic, and Zimmer Biomet, outside the submitted work).

This study was conducted at Rady Children’s Hospital, San Diego, CA.

IRB approval: IRB approval was obtained for this study (approval no. 150406, University of California, San Diego).

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Bastrom, T.P., Bartley, C.E., Newton, P.O. et al. Patient-Reported SRS-24 Outcomes Scores After Surgery for Adolescent Idiopathic Scoliosis Have Improved Since the New Millennium. Spine Deform 7, 917–922 (2019). https://doi.org/10.1016/j.jspd.2019.01.007

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  • DOI: https://doi.org/10.1016/j.jspd.2019.01.007

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