Summary: We evaluate differences in the pre‐operative Scoliosis Research Society Outcomes Instrument (SRS‐30) between US Caucasian, Black, Hispanic, and Asian, as well as Japanese ethnicities in adolescent idiopathic scoliosis.
Introduction: The SRS‐30 was developed using a US cohort of patients with adolescent idiopathic scoliosis. There are no comparative studies of SRS‐30 outcomes between multiple US ethnicities, and between US and non‐US cohorts.
Methods: Pre‐operative SRS‐30 outcomes data were collected from 2371 patients with adolescent idiopathic scoliosis from 5 different ethnic groups: US Caucasian (1534), Black (306), Hispanic (104), and Asian (218), as well as a Japanese cohort from Nogoya, Japan (209). Outcomes from the 5 domains of the SRS‐30 were analyzed and compared between groups. Pair‐wise comparisons in the SRS‐30 domains were adjusted for multiple comparisons using Bonferroni correction.
Results: Statistically significant differences (p < 0.05) are reported. Japanese and US Asians had higher Pain scores (Japanese 4.47, US Asian 4.47, Hispanic 4.10, Black 4.19, Caucasian 4.05) but lower Appearance scores than other groups (Japanese 2.79, US Asian 2.98, Hispanic 3.13, Caucasian 3.30, Black 3.45). Japanese had the highest Activity scores, while US Asians had the lowest (Japanese 4.30, Caucasian 4.16, Black 4.04, Hispanic 3.98, US Asian 3.83). Japanese had the highest Mental scores, while Hispanics had the lowest (Japanese 4.17, Black 4.01, Caucasian 3.94, US Asian 3.87, Hispanic 3.77). Japanese and Blacks had the highest Total scores (Japanese 3.90, Black 3.90, US Asian 3.76, Hispanic 3.75, Caucasian 3.84).
Conclusion: Among several significant differences, Japanese patients had the highest Pain, Activity, Mental and Total scores but the lowest Appearance scores. US Asians resembled Japanese patients in having high Pain scores and low Appearance scores, but differed in having lower Activity scores.
Significance: Ethnic and geographic variations in the SRS‐30 must be taken into account when counseling patients about operative treatment for adolescent idiopathic scoliosis, and when interpreting outcome studies.