Correlative Analysis of Radiological Measurements and 1-year SRS-22r in Early and Middle Adolescents with Adolescent Idiopathic Scoliosis: A Retrospective Study
Downloads
Background: Patient-reported outcomes are increasingly valuable for assessing the effectiveness of clinical interventions from the patient's perspective. This study aims to investigate the differences in the correlation between radiological measurements and 1-year postoperative SRS-22r domain scores in early (EA) and middle adolescence (MA) patients with adolescent idiopathic scoliosis (AIS), as well as analyze the correlation of these outcomes across different Lenke curve types.
Methods: We reviewed records of 87 female AIS patients who underwent scoliosis corrective surgery, collecting data on age, body mass index, preoperative and postoperative radiographic measurements, and 1-year postoperative quality of life assessments, including function, pain, self-image, and satisfaction scores from the SRS-22r questionnaire. Patients were categorized into subgroups based on age and the number of curves. The Spearman correlation test evaluated correlations between radiographic measures and SRS-22r domain scores across these subgroups.
Results: Significant correlations were found between self-image and preoperative main apical vertebral translation (AVT), Cobb angle, and trunk shift, with stronger associations in EA than MA. Pain had a weak inverse correlation with the postoperative main Cobb angle, notably in the one-curve group and more strongly in EA. Satisfaction scores decreased with age and were lower in the two-curve group and EA.
Conclusions: Cobb angle correction in AIS patients strongly correlates to postoperative self-image, particularly in Lenke type 2, 3, and 6. In Lenke type 1 and type 5, greater correction of the Cobb angle is associated with increased postoperative pain.
Teisberg E, Wallace S, O’Hara S. Defining and implementing value-based health care: a strategic framework. Acad Med. 2020;95(5):682-5.
Best O, Ban S. Adolescence: physical changes and neurological development. Br J Nurs. 2021;30(5):272–5.
Backes EP, Bonnie RJ. Adolescent development. In: The promise of adolescence: Realizing opportunity for all youth. Washington (DC): National Academies Press (US); 2019.
König AN, Himmler S, Buschner P, Sundmacher L. Experiences with and perception of patient-reported outcome measurement in patients undergoing knee and hip replacement in Germany. J Patient-Rep Outcomes. 2023;7(1):76.
Ritter M, Ling BM, Oberhauser I, Montagna G, Zehnpfennig L, Lévy J, et al. The impact of age on patient-reported outcomes after oncoplastic versus conventional breast cancer surgery. Breast Cancer Res Treat. 2021;187(2):437–46.
Zuckerman SL, Lai CS, Shen Y, Cerpa M, Lee NJ, Kerolus MG, et al. Do adult spinal deformity patients undergoing surgery continue to improve from 1-year to 2-years postoperative? Glob Spine J. 2023;13(4):1080–8.
Fekete TF, Mannion AF, Haschtmann D, Loibl M, Kleinstück FS, Jeszenszky DJ. Back pain and its change after surgery in adolescents and young adults with idiopathic scoliosis. Spine Deform. 2019;7(5):754–8.
Perry M, Starkweather A, Baumbauer K, Young E. Factors leading to persistent postsurgical pain in adolescents undergoing spinal fusion: an integrative literature review. J Pediatr Nurs. 2018;38:74–80.
Sanders JO, Carreon LY, Sucato DJ, Sturm PF, Diab M, Spinal Deformity Study Group. Preoperative and perioperative factors effect on adolescent idiopathic scoliosis surgical outcomes. Spine. 2010;35(20):1867–71.
Menon KV. Classification systems in adolescent idiopathic scoliosis revisited: is a three-dimensional classification needed? Indian Spine J. 2020;3(2):143.
Septian R, Rahyussalim. Validity and reliability study of the Indonesian version of the Scoliosis Research Society-22 revised (SRS-22r INA) questionnaire in adolescent idiopathic scoliosis at Cipto Mangunkusumo Hospital [Thesis]. Jakarta: Study Program of Orthopaedics and Traumatology; 2023.
Slattery C, Verma K. Classifications in brief: the Lenke classification for adolescent idiopathic scoliosis. Clin Orthop. 2018;476(11):2271–6.
Wang L, Wang YP, Yu B, Zhang JG, Shen JX, Qiu GX, et al. Relation between self-image score of SRS-22 with deformity measures in female adolescent idiopathic scoliosis patients. Orthop Traumatol Surg Res. 2014;100(7):797–801.
Mimura T, Ikegami S, Kuraishi S, Uehara M, Oba H, Takizawa T, et al. Residual thoracolumbar/lumbar curve is related to self-image after posterior spinal fusion for Lenke 1 and 2 curves in adolescent idiopathic scoliosis patients. J Neurosurg Pediatr. 2020;26(2):211–6.
Belli G, Toselli S, Latessa PM, Mauro M. Evaluation of self-perceived body image in adolescents with mild idiopathic scoliosis. Eur J Investig Health Psychol Educ. 2022;12(3):319–33.
Sanders AE, Andras LM, Iantorno SE, Hamilton A, Choi PD, Skaggs DL. Clinically significant psychological and emotional distress in 32% of adolescent idiopathic scoliosis patients. Spine Deform. 2018;6(4):435–40.
Elsamadicy AA, Adogwa O, Sergesketter A, Behrens S, Hobbs C, Bridwell KH, et al. Impact of age on change in self-image 5 years after complex spinal fusion (≥5 levels).World Neurosurg. 2017;97:112–6.
Zebracki K, Thawrani D, Oswald TS, Anadio JM, Sturm PF, Spine Deformity Study Group. Predictors of emotional functioning in youth after surgical correction of idiopathic scoliosis. J Pediatr Orthop. 2013;33(6):624–7.
Lacroix E, Smith AJ, Husain IA, Orth U, von Ranson KM. Normative body image development: A longitudinal meta-analysis of mean-level change. Body Image. 2023;45:238–64.
Pooja B. Physical appearance comparison and self-esteem among late adolescence and emerging adulthood. Int J Indian Psychol. 2023;11(4):2383-9.
Cirrincione PM, Thakur A, Zucker CP, Wisch JL, Groisser BN, Nguyen J, et al. Exploring correlations between pain and deformity in idiopathic scoliosis with validated self-reported pain scores, radiographic measurements, and trunk surface topographic measurements. J Pediatr Orthop. 2023;43(10):608-14.
Watanabe K, Hasegawa K, Hirano T, Uchiyama S, Endo N. Evaluation of postoperative residual spinal deformity and patient outcome in idiopathic scoliosis patients in Japan using the scoliosis research society outcomes instrument. Spine. 2007;32(5):550–4.
Wang H, Ma Z, Wu Z, Lin Y, Yu J, Qian X, et al. Biomechanical analysis of spinal range of motion and intervertebral disc loadings in normal and adolescent idiopathic scoliosis models. Front Bioeng Biotechnol. 2025;13:1473776.
Théroux J, Le May S, Hebert JJ, Labelle H. Back pain prevalence is associated with curve-type and severity in adolescents with idiopathic scoliosis: a cross-sectional study. Spine. 2017;42(15):E914-9.
Blankenburg M, Boekens H, Hechler T, Maier C, Krumova E, Scherens A, et al. Reference values for quantitative sensory testing in children and adolescents: developmental and gender differences of somatosensory perception. Pain. 2010;149(1):76–88.
Copyright (c) 2025 Journal Orthopaedi and Traumatology Surabaya
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
- The author acknowledges that the copyright of the article is transferred to the Journal of Orthopaedi and Traumatology Surabaya (JOINTS), whilst the author retains the moral right to the publication.
- The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution-Non Commercial-Share Alike 4.0 International License (CC BY-NC-SA).
- All published manuscripts, whether in print or electronic form, are open access for educational, research, library purposes, and non-commercial uses. In addition to the aims mentioned above, the editorial board is not liable for any potential violations of copyright laws.
- The form to submit the manuscript's authenticity and copyright statement can be downloaded here.
Journal of Orthopaedi and Traumatology Surabaya (JOINTS) is licensed under a Creative Commons Attribution-Non Commercial-Share Alike 4.0 International License.
Journal Orthopaedi and Traumatology Surabaya (JOINTS) (