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Differences in Postoperative Quality of Life Between Adolescent Patients With Idiopathic Scoliosis Residing in Urban and Rural Environments

Wang, Chuanfeng MD; Xu, Weidong MD; He, Shisheng MD; Gu, Suxi MD; Zhao, Yingchuan MD; Zhang, Jingtao MD; Zhu, Xiaodong MD; Li, Ming MD

doi: 10.1097/BRS.0b013e3181b9fe3e

Study Design. A prospective cross-sectional study.

Objective. To study the effects of living environment, rural and urban, on the postoperative quality of life in adolescent patients with idiopathic scoliosis (AIS) and to explore its causes.

Summary of Background Data. Many factors are capable of influencing the health-related quality of life of AIS patients including degree of the malformation, culture, treatment method, and the living environment of the patient.

Methods. Postoperative AIS patients (n = 117, 16 males and 101 females) were divided into 2 groups (the urban group and the rural group). All patients completed the simplified Chinese version of the SRS-22 scale and the scores on the individual domain, and items were compared between the 2 groups.

Results. The score on satisfaction of management domain in the urban group was higher than that in the rural group, but the score on the self-image/appearance in the urban group was significantly lower (P < 0.05). There were no significant differences in function/activity, pain or mental health domain between the 2 groups (P > 0.05). Scores for items 12, 15, and 18 in the function/activity domain, items 4, 6, and 10 in the self-image/appearance domain, and item 22 in the satisfaction of management domain were significantly different between the 2 groups (P < 0.05).

Conclusion. Living environment may influence the assessment results of the postoperative quality of life in AIS patients. The effects of environment (i.e., rural vs. urban) should be considered when using the SRS-22 scale to evaluate the quality of life of the patients.

Many factors are capable of influencing health-related quality of life of adolescent idiopathic scoliosis patients. We found that residing in an urban versus rural environment does impact health-related quality of life. Clinicians must consider living environment when assessing health-related quality of life in adolescent idiopathic scoliosis patients to make the scores more objective and comparable.

From the Department of Spine Surgery, Changhai Hospital, the Second Military Medical University, Shanghai, People's Republic of China.

Acknowledgment date: September 30, 2008. First revision date: February 18, 2009. Second revision date: April 29, 2009. Third revision date: June 18, 2009. Acceptance date: June 22, 2009.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Supported by National High Technology Research and Development Program of China (grant #: 30571888).

CW and WX contributed equally to this study.

Address correspondence and reprint requests to Ming Li, MD, Department of Spine Surgery, Changhai Hospital, 174 Changhai Road, Shanghai 200433, People's Republic of China; E-mail:

© 2010 Lippincott Williams & Wilkins, Inc.