Baldus Christine, Bridwell Keith H, Harrast John, Edwards Charles, Glassman Steven, Horton William, Lenke Lawrence G, Lowe Thomas, Mardjetko Steve, Ondra Stephen, Schwab Frank, Shaffrey Christopher
Department of Orthopedics, Washington University, St. Louis, MO 63110, USA.
Spine (Phila Pa 1976). 2008 Sep 15;33(20):2214-8. doi: 10.1097/BRS.0b013e31817c0466.
Prospective, observational study.
To further validate the Scoliosis Research Society (SRS) instrument by comparing scores of adult deformity patients with no prior history of spine surgery to the scores of normal adult volunteers in age-gender matched groups.
Efforts have been made to validate the SRS questionnaire in adolescent and adult deformity patients. An important psychometric attribute of any quality of life tool is its ability to discriminate between subjects with and without the condition of interest. Discriminate validity of the SRS questionnaire has not been established in the primary (no prior surgical treatment) adult deformity population.
The SRS questionnaire was issued prospectively to 935 primary adult deformity patients with a diagnosis of idiopathic or de novo scoliosis and minimum Cobb angle of 30 degrees (average Cobb angle: 54 degrees; range: 30 degrees-132 degrees). Five hundred forty-three patients were treated nonsurgically while 392 patients underwent surgical intervention. Baseline SRS scores of the deformity population were compared to 1222 volunteers with no history of spine disease randomly sampled from the US population. Analysis between the 2 populations was broken down into 6 age-gender groups: male/female; 20-40, 41-60, 61-80 years of age.
SRS domain scores of the deformity subgroups demonstrated significant statistical differences from their corresponding age-gender matched normative group. The only exceptions were the mental health domain in the older males, 61-80 years of age. The average SRS subscore for each age-gender subgroup was less than the tenth percentile in the corresponding normative population, indicating substantial limitations in these patients.
Our findings confirm the SRS instrument has excellent discriminate validity in the adult population. It appears to be disease-specific in the domains of pain, appearance and activity in adult spinal deformity patients who have not had prior surgery.
前瞻性观察性研究。
通过比较无脊柱手术史的成人脊柱畸形患者与年龄性别匹配的正常成人志愿者的评分，进一步验证脊柱侧弯研究学会（SRS）工具。
已努力在青少年和成人脊柱畸形患者中验证SRS问卷。任何生活质量工具的一个重要心理测量属性是其区分有和无相关疾病受试者的能力。SRS问卷在原发性（无既往手术治疗）成人脊柱畸形人群中的区分效度尚未确立。
前瞻性地向935例诊断为特发性或新发脊柱侧弯且最小Cobb角为30度（平均Cobb角：54度；范围：30度 - 132度）的原发性成人脊柱畸形患者发放SRS问卷。543例患者接受非手术治疗，392例患者接受手术干预。将脊柱畸形人群的基线SRS评分与从美国人群中随机抽取的1222例无脊柱疾病史的志愿者进行比较。两组人群之间的分析分为6个年龄性别组：男性/女性；20 - 40岁、41 - 60岁、61 - 80岁。
脊柱畸形亚组的SRS领域评分与相应年龄性别匹配的正常组存在显著统计学差异。唯一的例外是61 - 80岁老年男性的心理健康领域。每个年龄性别亚组的平均SRS子评分低于相应正常人群的第十百分位数，表明这些患者存在明显局限性。
我们的研究结果证实SRS工具在成人人群中具有出色的区分效度。对于未接受过手术的成人脊柱畸形患者，在疼痛、外观和活动领域似乎具有疾病特异性。
