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Decrease of Self-Concept in Adolescent Patients With Mild to Moderate Scoliosis After Conservative Treatment

Zhang, Jingtao, MD*; Wang, Dayi, MD; Chen, Ziqiang, MD; Gao, Juan, MPsy§; Yu, Xiuchun, MD*; Sun, Haining, MD*; Li, Ming, MD, PhD

doi: 10.1097/BRS.0b013e3181fef60f
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Study Design. Comparative study.

Objective. To analyze the effect of conservative treatment on self-concept in patients with mild to moderate scoliosis.

Summary of Background Data. The choice of surgery or conservative treatment in adolescent idiopathic scoliosis is usually done on the basis of the magnitude of the initial Cobb angle in these patients. However, mental effect of the therapy choice should be considered.

Methods. Between August 2006 and December 2008, 65 patients with adolescent idiopathic scoliosis were selected for this study. Twenty-two patients with Cobb angles between 20° and 40° received conservative treatment, 18 patients with Cobb angles between 40° and 50° received conservative treatment, and 25 patients with Cobb angles between 40° and 50° received surgical treatment. All subjects were required to fill the Children's Self-Concept Scale at the beginning of the study and at the follow-up visit 1 year later. Scores on this scale were compared among the three different groups, and between the initial visit and the follow-up visit in each group.

Results. At the initial test, the total self-concept score was significantly higher in the group of patients with Cobb angles between 20° and 40° than in the two groups with Cobb angles between 40° and 50°. At the follow-up visit, the total self-concept score had increased significantly in the surgically treated group (Cobb angle between 40° and 50°), however, it had decreased in the two conservatively treated groups. No significant difference was seen between the two conservatively treated groups in the amount by which the self-concept score had decreased at follow-up.

Conclusion. In terms of mental health, conservative treatment is not ideal for patients with mild to moderate scoliosis, and in particular, it is not conducive to mental health in patients with Cobb angles between 40° and 50°.

A comparative study was performed to a cohort of adolescent patients with mild to moderate scoliosis to analyze the effect of conservative treatment on their self-concept. The results suggested that conservative treatment is not conducive to mental health in patients with Cobb angles between 40° and 50°.

* Department of Orthopaedic Surgery, The General Hospital of Jinan Military Commanding Region, Jinan, People's Republic of China.

Department of Spinal Surgery, The Affiliated Hospital, The Yuyang Medical School, ShiYan, Hubei, People's Republic of China.

Department of Orthopaedic Surgery, The Affiliated Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China.

§ Department of Psychology, South of China Normal University, Guangzhou, People's Republic of China.

Address correspondence and reprint requests to Ming Li, MD, PhD, Department of Orthopaedic Surgery, Changhai Hospital, 174 Changhai Rd, Shanghai 200433, People's Republic of China; E-mail: buyning@yahoo.com.cn

Acknowledgement date: January 6, 2010; 1st Revise: March 23, 2010; 2nd Revise: June 29, 2010; 3rd Revise: September 13, 2010; Accept: September 20, 2010.

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

No 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.

The authors Jingtao Zhang, Dayi Wang, and Ziqiang Chen contributed equally to this work.

© 2011 Lippincott Williams & Wilkins, Inc.