Lonner Baron S, Brochin Robert, Lewis Roxanne, Vig Khushdeep S, Kassin Gabrielle, Castillo Andrea, Ren Yuan
Mount Sinai Hospital, 1 Gustave L. Levy Place, New York, NY 10029-6574, USA.
Mount Sinai Hospital, 1 Gustave L. Levy Place, New York, NY 10029-6574, USA.
Spine Deform. 2019 Sep;7(5):741-745. doi: 10.1016/j.jspd.2018.12.005.
Body Image Disturbance Questionnaire-Scoliosis version (BIDQ-S) is a sensitive outcomes instrument to evaluate improvements in body image-related psychosocial effects with surgical correction.
Prospective observational study.
The BIDQ-S was previously validated (convergent validity, internal consistency) as a tool to assess body image-related distress and psychosocial impairment in adolescent idiopathic scoliosis (AIS). This study was conducted to evaluate responsiveness to change in the BIDQ-S associated with surgical treatment of AIS two years postoperatively to complete the validation of this questionnaire.
Seventy-five consecutive operative AIS patients were enrolled and completed BIDQ-S and Scoliosis Research Society-22 (SRS-22) at preoperative and two-year postoperative visits. Demographic and radiographic data were collected. Preoperative and two-year postoperative BIDQ-S (1 = best, 5 = worst) and SRS-22 scores (1 = worst, 5 = best) were compared using paired t test. Correlations between BIDQ-S and SRS-22 scores were evaluated by linear regression.
Eighty-four percent of the subjects were females, with average age at surgery of 14.4 ± 1.6 years. The mean follow-up was 2.26 years (range 2.0-4.5). The major Cobb was corrected from 50.0° ± 7.2° to 14.2° ± 5.8° (Δ = 71.3% ± 12.1%; p < .0001). There was a significant improvement in BIDQ-S scores after surgery (1.64 ± 0.51 to 1.21 ± 0.38, p < .0001). BIDQ-S improvements were correlated with change in SRS self-image (p = .0055), activity (p = .0057), mental (p = .0018), and overall mean (p = .0007) domains. Preoperative, two-year postoperative, and Δ BIDQ-S score were not associated with major Cobb magnitude, truncal rotation, or Lenke curve type. Patients who reached SRS-22r minimal clinically important difference (MCID) in activity and self-image domains had worse preoperative BIDQ scores than those who did not reach MCID (activity 1.91 vs. 1.54 [1 = best, 5 = worst], p = .0099; self-image 2.08 vs. 1.51, p < .0001). Greater improvement in BIDQ-S was noted in patients who reached MCID in SRS-22 self-image than those who did not (Δ = 0.77 vs. 0.38, p = .0052).
BIDQ-S is responsive to surgical correction of AIS. The BIDQ-S is a valuable clinical outcome tool to assess the psychosocial effects of scoliosis in adolescents augmenting existing outcome instruments.
身体意象障碍问卷 - 脊柱侧凸版（BIDQ - S）是一种敏感的结局评估工具，用于评估手术矫正后与身体意象相关的心理社会效应的改善情况。
前瞻性观察研究。
BIDQ - S先前已被验证（收敛效度、内部一致性）为评估青少年特发性脊柱侧凸（AIS）中与身体意象相关的痛苦和心理社会损害的工具。本研究旨在评估术后两年与AIS手术治疗相关的BIDQ - S对变化的反应性，以完成该问卷的验证。
连续纳入75例接受手术的AIS患者，并在术前和术后两年随访时完成BIDQ - S和脊柱侧凸研究学会 - 22（SRS - 22）问卷。收集人口统计学和影像学数据。使用配对t检验比较术前和术后两年的BIDQ - S（1 = 最佳，5 = 最差）和SRS - 22评分（1 = 最差，5 = 最佳）。通过线性回归评估BIDQ - S与SRS - 22评分之间的相关性。
84%的受试者为女性，手术平均年龄为14.4±1.6岁。平均随访时间为2.26年（范围2.0 - 4.5年）。主弯Cobb角从50.0°±7.2°矫正至14.2°±5.8°（Δ = 71.3%±12.1%；p <.0001）。术后BIDQ - S评分有显著改善（1.64±0.51至1.21±0.38，p <.0001）。BIDQ - S的改善与SRS自我形象（p =.0055）、活动（p =.0057）、心理（p =.0018）和总体平均（p =.0007）领域的变化相关。术前、术后两年和ΔBIDQ - S评分与主弯Cobb角大小、躯干旋转或Lenke曲线类型无关。在活动和自我形象领域达到SRS - 22r最小临床重要差异（MCID）的患者术前BIDQ评分比未达到MCID的患者更差（活动方面1.91对1.54 [1 = 最佳，5 = 最差]，p =.0099；自我形象方面2.08对1.51，p <.0001）。在SRS - 22自我形象方面达到MCID的患者BIDQ - S改善程度大于未达到的患者（Δ = 0.77对0.38，p =.0052）。
BIDQ - S对AIS手术矫正有反应。BIDQ - S是一种有价值的临床结局工具，可用于评估青少年脊柱侧凸的心理社会效应，补充现有的结局评估工具。
