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Does Brace Treatment Leave a Scar in the Mind? Body Appearance and Quality of Life in Adult AIS Patients ‐ Comparison Between Patients Brace Treated or Observed During Adolescence: Paper #14

Danielsson, Aina J. MD, PhD (Sahlgrenska University Hospital); Hasserius, Ralph MD, PhD; Ohlin, Acke MD, PhD; Nachemson, Alf

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Spine Journal Meeting Abstracts: September 2009 - Volume 10 - Issue - p 61–62
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Introduction: The previously published long term results of the prospective SRS brace study included two consecutive series of immature patients with AIS of moderate curve size (Cobb 25°‐35°). 77 out of the original 100 patients attended the complete follow up mean 16 years after maturity, 40 observed only and 37 brace treated patients. Both groups were equal in terms of age at FU (mean 32 y), curve size at inclusion (mean 30°) or at FU (mean 35°, 19° ‐ 48°).

Methods: Two quality of life questionnaires (SRS‐22 and SF‐36) were answered. Trunk asymmetry was measured with Bunnell scoliometer. The pictures of the Spinal Appearance Questionnaire were evaluated for the subjective opinion on body appearance, in which seven aspects of asymmetry are graded on a scale from 1–5, where 5 reflects the worst asymmetry. The points were then added (a total of seven points reflecting the least distorted appearance and 35 the most) and compared towards curve size, scoliometer readings and quality of life results.

Results: No difference was found between the groups in terms of trunk rotation, mean 10.7 (range 0–18) for observed only and 10.8 (range 5–18) for braced patients. Observed patients found their body appearance to be significantly less distorted than the braced patients, mean 12.9 (range 7–25) and 15.0 (range 7–29), p=0.0028 respectively. Scores for satisfaction with management and total score of SRS‐22 were inversely and moderately correlated to the degree of distortion of the body appearance for both groups (rs= ‐0.50 for braced and rs = ‐0.56 for observed patients). The body asymmetry was not correlated to the function for any of the groups. For SF‐36 domains the correlation coefficients were rather low and varied from ‐0.27 to 0.34 in the braced group and from ‐0.47 to 0.14 in the observed group.

Conclusion: Patients with less body asymmetry were more satisfied with treatment and the total score of SRS‐22 was affected positively. Despite similar curve sizes as well as trunk rotation of braced and observed patients, the observed patients found their body appearance less distorted than the braced patients.

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© 2009 Lippincott Williams & Wilkins, Inc.