Body Image Disturbance Improvement After Operative Correction of Adolescent Idiopathic Scoliosis

Lonner, Baron S.; Brochin, Robert L.; Lewis, Roxanne E.; Vig, Khushdeep S.; Kassin, Gabrielle; Castillo, Andrea; Ren, Yuan

doi:10.1016/j.jspd.2018.12.005

Cited by 11 publications

(7 citation statements)

References 18 publications

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“…Several studies indicated that the degree of curve was related to self-image [ 2 , 25 ]; however, studies showing the opposite result also exist [ 5 , 34 ]. In many studies, surgery was related to improvement of self-image and quality of life [ 7 , 10 , 19 , 28 ]. With regard to behavioral disorders, eating disorders have been reported to be associated with AIS [ 31 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

Is There an Association Between Psychiatric Disorders and Adolescent Idiopathic Scoliosis? A Large-database Study

Lee

Chae

Kwon

et al. 2021

Clin Orthop Relat Res

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Background Children with adolescent idiopathic scoliosis (AIS) have reduced quality of life related to poor self-image, perhaps because of cosmetic concerns. However, there has not been a large-database epidemiologic study on the association between psychiatric disorders and scoliosis. Questions/purposes Using the Korean National Health Insurance database, we asked: (1) How common are psychiatric disorders among children with AIS? (2) After controlling for gender, age, insurance type, and residential district, are psychiatric disorders more common among children with AIS than among age-matched controls? Methods A retrospective analysis was conducted using sample datasets from the Health Insurance Review and Assessment Service from 2012 to 2016, which is a 10% randomly extracted sample of total inpatients and outpatients each year. The mean number of total patients in each dataset was 1,047,603 ± 34,534. The mean number of children with AIS was 7409 ± 158 for each year. The age criteria was 10 to 19 years for the matching. Mood disorders, anxiety disorders, and behavioral disorders were selected as disorders possibly associated with AIS. We identified children with AIS who had any of the disorders above, and we obtained the prevalence of these disorders based on diagnostic codes. As an exploratory analysis, clinically meaningful variables were selected among the available codes in the dataset, and a univariable logistic regression test was performed for each variable. A multivariable logistic regression test with advanced variables was performed to identify the adjusted odds ratios of psychiatric disorders in children with AIS. Results The median (range) prevalence of psychiatric disorders in children with AIS from 2012 to 2016 was 7% (6% to 7%). Compared with children who did not have AIS, and after controlling for gender, age, insurance type, and residential district, children with AIS were more likely to have psychiatric disorders in all 5 years. The adjusted ORs of psychiatric disorders in children with AIS compared with children who did not have AIS ranged from 1.47 to 1.74 (2012: OR 1.60 [95% CI 1.46 to 1.75]; p < 0.001; 2013: OR 1.73 [95% CI 1.58 to 1.89]; p < 0.001; 2014: OR 1.74 [95% CI 1.59 to 1.91]; p < 0.001; 2015: OR 1.71 [95% CI 1.56 to 1.88]; p < 0.001; 2016: OR 1.47 [95% CI 1.33 to 1.62]; p < 0.001). Conclusion Considering the higher prevalence of psychiatric disorders in children with AIS compared with children who did not have AIS, children with AIS and their parents should be counseled about the increased risk of deteriorating mental health of the patients, and surgeons should provide early referral to pediatric psychiatrists. Further studies should investigate the effect of the factors related to AIS, such as curve type, Cobb angle, and treatment modality. Level of Evidence Level III, prognostic study.

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Section: Discussionmentioning

confidence: 99%

Is There an Association Between Psychiatric Disorders and Adolescent Idiopathic Scoliosis? A Large-database Study

Lee

Chae

Kwon

et al. 2021

Clin Orthop Relat Res

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“…The largest difference between the IR and IE cohorts was the self-image domain, which achieved MDMD with a difference of 0.69. The influences of different treatment approached on SRS self-image scores conflict with several studies finding improvement after surgery 33,34 and others finding no significant differences between treatment approaches. [35][36][37][38] However, this study is the first to compare differences in self-image sub-item scores by treatment with IR or IE.…”

Section: Discussionmentioning

confidence: 85%

Late Infection After Spinal Fusion for Adolescent Idiopathic Scoliosis: Implant Exchange Versus Removal

Benes

Shufflebarger

Shah

et al. 2023

Journal of Pediatric Orthopaedics

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Background: Late infection after posterior spinal arthrodesis for adolescent idiopathic scoliosis (AIS) is the leading cause of late revision. While implant removal and antibiotic therapy are usually curative, patients may experience deformity progression. The goal of this study was to compare outcomes after implant exchange (IE) or removal (IR) to treat late-onset (≥1 y postoperative) deep surgical site infection (SSI) after spinal arthrodesis in patients with AIS. Methods: Using a multicenter AIS registry, patients who underwent posterior spinal fusion between 2005 and 2019 and developed late deep SSI treated with IE or IR were identified. Radiographic, surgical, clinical, and patient-reported outcomes at most recent follow-up were compared. Results: Of 3,705 patients, 47 (1.3%) developed late infection 3.8±2.2 years (range 1 to 9.7 y) after index surgery. Mean follow-up after index surgery was 6.1 years, with 2.8 years (range 25 to 120 mo) of follow-up after revision surgery. Twenty-one patients were treated with IE and 26 with IR. At the latest follow-up, average major-curve loss of correction (1° vs 9°, P<0.001) and increase in kyphosis (1° vs. 8°, P=0.04) were smaller in the IE group than in the IR group. Two IR patients but no IE patients had reoperation. Patients who underwent IE had higher Scoliosis Research Society 22-Item Patient Questionnaire (SRS-22) total scores (4.38 vs. 3.81, P=0.02) as well as better subscores for self-image, function, and satisfaction at the latest follow-up than those who underwent IR only. There were no significant between-group differences in operative duration, estimated blood loss, length of hospital stay, or changes in SRS-22 total scores. No patient had a subsequent infection during the follow-up period. Conclusions: When treating late-onset deep SSI after posterior spinal fusion for AIS, single-stage IE is associated with better maintenance of major curve correction, sagittal profile, and patient-reported outcomes and fewer reoperations compared with IR, with no significant differences in blood loss, operative duration, or length of stay. No time interval from index surgery to IR was observed where the corrected deformity remained stable. Both techniques were curative of infection. Level of Evidence: Level III

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“…Несмотря на то, что в настоящее время единственное эффективное средство медицинской реабилитации больных -хирургический метод коррекции, тем не менее, применяются различные методики операций, реабилитационные программы, способы оценки результатов лечения. В связи с этим работы по лечению сколиоза различаются по многим позициям, в частности, по оценке результатов рентгенологического лечения и данным анкет-опросников [18][19][20][21]. В нашей работе использована анкета опросник SRS-30 [22][23][24].…”

Section: Discussionunclassified

Evaluation of the idiopathic scoliosis of varying severity treatment effectiveness with transpedicular systems

Zeynalov¹

2021

Innovacionnaâ medicina Kubani

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Introduction Significant success has been achieved in the development of new methods of treatment and rehabilitation of patients with idiopathic scoliosis, however, in many aspects of this problem there is no unambiguous approach to the choice of a correction method, assessment of treatment results.Objective To study the results of treatment of patients with idiopathic scoliosis according to X-ray and MSCT data, as well as according to the questionnaire – the SRS-30, depending on the degrees of the deformity, the type of scoliosis.Material and methods The study is retrospective, single center. Evidence level – IV. In 300 patients with idiopathic scoliosis of varying severity at the age from 10 to 50 years, the immediate and long-term results of elimination of spinal deformity by the method of internal transpedicular fixation were studied. In the study we used polypositional radiography, multislice computed tomography (MSCT) and questionnaire SRS-30.Results In patients with spinal deformity up to 60 ° a year after surgery, no loss of correction was found. After elimination of the deformity at 60–90 °, loss of correction up to 2 ° was observed in 3.6% of patients. In patients with deformity greater than 90 °, the average postoperative progression of scoliotic deformity was 3.5 ± 0.7 °. When examining patients after 2–5 years, there was no loss of correction in the group with initial spinal deformity up to 60 ° and in the group from 60–90 °. In patients with deformity greater than 90 °, the postoperative progression of scoliotic deformity in persons over 25 years old was 4.5 ± 0.6 °, which is associated with degenerative changes in the spine.Conclusion The study of immediate and long-term results showed that 1 year after treatment, 94% of patients rated the treatment result as excellent and good, in 6% – as satisfactory. All patients noted a positive effect of the cosmetic and functional results of treatment, while 56% believed that they looked “better” than before surgery (4 points), 44% rated the effect at 5 points and noted that they looked “much better”. Long-term results were studied in 50 patients 10 years after surgery.

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Body Image Disturbance Improvement After Operative Correction of Adolescent Idiopathic Scoliosis

Cited by 11 publications

References 18 publications

Is There an Association Between Psychiatric Disorders and Adolescent Idiopathic Scoliosis? A Large-database Study

Is There an Association Between Psychiatric Disorders and Adolescent Idiopathic Scoliosis? A Large-database Study

Late Infection After Spinal Fusion for Adolescent Idiopathic Scoliosis: Implant Exchange Versus Removal

Evaluation of the idiopathic scoliosis of varying severity treatment effectiveness with transpedicular systems

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