Department of Neurological Surgery, University of California, San Diego, CA, USA.
Department of Orthopedic Surgery, Rady Children's Hospital, 3020 Children's Way, San Diego, CA, 92123, USA.
Spine Deform. 2024 Sep;12(5):1179-1202. doi: 10.1007/s43390-024-00875-2. Epub 2024 May 2.
To review the current literature surrounding the assessment of self-image in pediatric and adult spinal deformity.
The literature were reviewed for studies examining patient-reported outcome measurements (PROM) and self-image in pediatric and adult spinal deformity. PROM performance metrics were collected and described. The relationships between self-image PROM and patient outcomes, including satisfaction, were described.
Several self-image PROM exist, including the Scoliosis Research Society-22r (SRS-22r) self-image domain, the Body Image Disturbance Questionnaire (BIDQ), and the Spinal Appearance Questionnaire (SAQ). The most commonly used is the self-image domain of the SRS-22r. It is validated in adult and pediatric spinal deformity and is correlated with patient desire for surgery and satisfaction after surgery. This domain is limited by floor and ceiling effects.
Self-image assessment is critical to both pediatric and adult spinal deformity surgeries. The SRS-22r self-image domain is the most frequently reported PROM for this health domain. While valid in both surgical cohorts, this PROM is affected by floor and ceiling effects which limits the ability to discriminate between health states. Given the overall importance of this domain to patients with spinal deformity further efforts are needed to improve discrimination without gross increases in PROM question burden, which may limit broad acceptance and use.
回顾有关小儿和成人脊柱畸形患者自我形象评估的当前文献。
对评估小儿和成人脊柱畸形患者的患者报告结局测量（PROM）和自我形象的研究进行文献回顾。收集并描述 PROM 性能指标。描述自我形象 PROM 与患者结局（包括满意度）之间的关系。
存在几种自我形象 PROM，包括脊柱畸形研究协会 22 项问卷修订版（SRS-22r）自我形象领域、身体形象障碍问卷（BIDQ）和脊柱外观问卷（SAQ）。最常用的是 SRS-22r 的自我形象领域。它在成人和小儿脊柱畸形中得到验证，并与患者对手术的渴望和手术后的满意度相关。该领域受到地板和天花板效应的限制。
自我形象评估对小儿和成人脊柱畸形手术都很重要。SRS-22r 自我形象领域是该健康领域最常报告的 PROM。虽然在两个手术队列中均有效，但该 PROM 受到地板和天花板效应的影响，限制了区分健康状态的能力。鉴于该领域对脊柱畸形患者的整体重要性，需要进一步努力提高区分能力，而不会大幅增加 PROM 问题负担，这可能会限制其广泛接受和使用。
