A Cross-Sectional Investigation on Deformity-Related Stress in Patient’s with Adolescent Idiopathic Scoliosis (AIS) after Brace Weaning

Health-Related Quality of Life (HRQL) of scoliosis patient’s has been investigated in numerous studies. The perception of health, self- and body image and participation in physical activities seems to be an issue for patient’s with spinal deformities. In previous studies it was concluded that adolescents with scoliosis have only “little stress” associated with their deformity. This study was performed to scientifically objectify the outcome of patient’s following brace treatment with respect to quality of life using the BSSQ-Deformity.

Materials and Methods: All 42 consecutive female patient’s returning to the office of the first author for a followup x-ray after brace weaning (February to December 2013) were asked to complete the BSSQ-Deformity. The average age of the patient’s was 15.8 years and the average treatment duration was 35.8 months. The patient’s average age at start of treatment was 12.8 years. In addition to the BSSQ we also evaluated the treatment results of this sample of patient’s with respect to Cobb angle (maximum angle in combined curvatures) and angle of trunk rotation (ATR) for thoracic and lumbar areas.

Results: The average BSSQ score was 22/24 with five patient’s scoring less than 20/24. The average Cobb angle at the start of treatment was 29.2° (range 15–69°) and after weaning it was 25.8°. None of the patient’s experienced a progression of > 5°, while 14 patient’s (33%) improved > 5° over the period of brace treatment.

Discussion: Patient’s with adolescent idiopathic scoliosis seem to be able to cope very well with their deformity. A BSSQ score of 22/24 indicates that cessation of brace treatment had very little impact on the patient’s quality of life.

Conclusions: Scoliosis-related stress is not necessarily a problem for patients with moderate angles of curvature after brace weaning when recent asymmetric bracing standards are applied. An improvement in the Cobb angle and trunk deformity is possible when recent asymmetric bracing standards are applied. Considering the small impact that AIS obviously has on patient’s participation in physical activities and quality of life, a general indication for surgery cannot be derived for treating this condition. Patient satisfaction after treatment in this cohort seems better than in the pilot investigation.