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Long-Term Effects on Personality Development in Patients with Adolescent Idiopathic Scoliosis: Influence of Type of Treatment


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In a series of 157 patients treated surgically and/or with Milwaukee braces, constituting 83% of the original criterion patients with adolescent idiopathic scoliosis, treated in the Department of Orthopaedics in Gothenburg, Sweden, from 1969 to 1974, a specific psychologic interview was carried out an average of 9 years after treatment. The 92 surgical patients all wore a Milwaukee brace postoperatively for 6-9 months and were gradually weaned over the next year (17 ± 2 months). The brace-treated patients wore their braces full time for 18 months and part time for another 8 months (26 ± 3 months). The psychologic portion of the study was a semistructured interview aimed at evaluating reactions in connection with the diagnostic phase, attitudes and reactions to the treatment, attitudes to the hospital staff, and body image concepts at follow-up. The brace-treated patients more often said that they experienced more fear and anxiety when informed about the diagnosis than did the surgical patients (53% and 38%, respectively). In both groups, nearly all patients initially had negative attitudes to the brace treatment. Most of the surgically treated patients gradually accepted the brace, whereas very few of the other group did so. Forty percent in the brace group had negative experiences with the hospital staff, but only 15% in the other group reported negative experience. Several years after completed treatment, one-half of the brace group had definite signs of negative body image concept, whereas this emotional disturbance was found in 33% of the surgically treated patients. Furthermore, only 8% in the brace-treated group had a definite positive body image, vs. 27% in the surgical group. We found no relation between later curve increase (ten patients>10°, all in the brace group) or residual rib deformity and negative body image.

*From the Department of Psychology, University of Göteborg, Sweden

†From the Department of Orthopaedic Surgery I, University of Göteborg, Sweden

© Lippincott-Raven Publishers.