University of Alberta, Edmonton, Alberta, Canada.
Spine (Phila Pa 1976). 2009 Oct 15;34(22):2450-7. doi: 10.1097/BRS.0b013e3181af28bf.
Prospective cross-sectional measurement study.
To determine the ability of the Scoliosis Research Society (SRS)-22 questionnaire to discriminate among management and scoliosis severity subgroups and to correlate with internal and external measures of curve severity.
In earlier studies of the SRS-22 discriminative ability, age was not a controlled factor. The ability of the SRS-22 to predict curve severity has not been thoroughly examined.
The SRS-22 was completed by 227 females with adolescent idiopathic scoliosis. Using Analysis of covariance analyses controlling for age, the SRS-22 scores were compared among management subgroups (observation, brace, presurgery, and postsurgery) and curve-severity subgroups (in nonoperated subjects: Cobb angles of <30 degrees, 30 degrees -50 degrees, and >50 degrees). A stepwise discriminant analysis was used to identify the SRS-22 domains most discriminative for curve-severity categories. Correlation between SRS-22 scores and radiographic or surface topography measurements was used to determine the predictive ability of the questionnaire.
Pain was better for subjects treated with braces than for those planning surgery. Self-image was better for subjects under observation or postsurgery than for those planning surgery. Satisfaction was better for the brace and postsurgery subgroups than for the observation or presurgery subgroups. Statistically significant mean differences between subgroups were all larger than 0.5, which is within the range of minimal clinically important differences recommended for each of the 5-point SRS-22 domain scoring scales. Pain and mental health were worse for those with Cobb angles of >50 degrees than with Cobb angles of 30 degrees to 50 degrees. Self-image and total scores were worse for those with Cobb angles of >50 degrees than both other subgroups. Using discriminant analysis, self-image was the only SRS-22 domain score selected to classify subjects within curve severity subgroups. The percentage of patients accurately classified was 54% when trying to classify within 3 curve severity subgroups. The percentage of patients accurately classified was 73% when classifying simply as those with curves larger or smaller than 50 degrees .
Pain, self-image, and satisfaction scores could discriminate among management subgroups, but function, mental health and total scores could not. The total score and all domain scores except satisfaction discriminated among curve-severity subgroups. Using discriminant analysis, self-image was the only domain retained in a model predicting curve-severity categories.
前瞻性横断面测量研究。
确定 Scoliosis Research Society（SRS）-22 问卷区分管理和脊柱侧弯严重程度亚组的能力，并与脊柱侧弯严重程度的内部和外部测量相关。
在之前的 SRS-22 区分能力研究中，年龄不是一个控制因素。SRS-22 预测脊柱侧弯严重程度的能力尚未得到彻底研究。
227 名患有青少年特发性脊柱侧弯的女性完成了 SRS-22。使用协方差分析（age 为控制因素）比较管理亚组（观察、支具、术前和术后）和脊柱侧弯严重程度亚组（未手术患者：Cobb 角<30 度、30 度-50 度和>50 度）之间的 SRS-22 评分。采用逐步判别分析确定对脊柱侧弯严重程度类别的最具判别力的 SRS-22 域。SRS-22 评分与放射学或表面形貌测量之间的相关性用于确定问卷的预测能力。
接受支具治疗的患者疼痛评分优于计划手术的患者。观察或术后患者的自我形象优于计划手术的患者。支具和术后亚组的满意度优于观察或术前亚组。各组之间的平均差异均大于 0.5，这在每个 5 分 SRS-22 域评分量表推荐的最小临床重要差异范围内。Cobb 角>50 度的患者疼痛和心理健康状况较差，Cobb 角为 30 度至 50 度的患者则较差。Cobb 角>50 度的患者自我形象和总分均较差，两组均较差。使用判别分析，自我形象是唯一选择用于对脊柱侧弯严重程度亚组进行分类的 SRS-22 域评分。当试图在 3 个脊柱侧弯严重程度亚组内进行分类时，54%的患者被准确分类。当简单地将其分类为 Cobb 角大于或小于 50 度的患者时，73%的患者被准确分类。
疼痛、自我形象和满意度评分可以区分管理亚组，但功能、心理健康和总分则不能。总分和除满意度外的所有域评分均可区分脊柱侧弯严重程度亚组。使用判别分析，自我形象是唯一保留在预测脊柱侧弯严重程度类别的模型中的域。
