Demographic factors affect Scoliosis Research Society-22 performance in healthy adolescents: a comparative baseline for adolescents with idiopathic scoliosis.

STUDY DESIGN: Prospective analysis. OBJECTIVE: The purpose of this study was to: (1) evaluate the influence of variable demographic factors on the Scoliosis Research Society (SRS)-22 performance and (2) evaluate SRS-22 performance in normal adolescents without scoliosis to establish a comparative baseline for adolescent idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: The SRS-22 instrument has been used widely to evaluate patients with scoliosis but no study has characterized how variable patient demographics in normal, unaffected individuals may influence SRS-22 scores. METHODS: Healthy adolescents at a high school clinic and at referring pediatricians' private offices were asked to anonymously complete the SRS-22 instrument: 22 questions scaled 1-5 (highest). Additional questions assessed household income, race (white, Hispanic, African-American, other), gender, household status (single vs. dual parent), and body mass index. ANOVA and multivariate regression analyses were used to identify statistically significant factors (P < 0.05). RESULTS: Four hundred fifty unaffected adolescents completed the SRS-22 (62% female, 38% male; mean age 16 (range, 9.3-21.8), mean body mass index 22.8 (range, 13.5-47.5). Mean SRS-22 performance was 4.1 ± 0.5 (Activity: 4.0 ± 0.6; Pain: 4.3 ± 0.6; Image: 4.2 ± 0.6; Mental: 3.8 ± 0.8, Mean: 4.1 ± 0.5). Whites scored higher in the activity domain than Hispanic and other ethnicities, while African Americans scored higher in the pain domain than Hispanics (P < 0.05 for both). From the lowest income range to 125,000 dollars/yr, household income had a positive effect on the activity, image and mean SRS-22 score (P < 0.05 for all). Males scored higher than females in the mental health domain and mean SRS-22 (P < 0.0001). Dual parent versus single parent households had higher activity and mean SRS-22 scores (P < 0.005). CONCLUSION: We report that male gender, dual parent household, white race and increased household income were predictive of higher SRS-22 scores in healthy adolescents without scoliosis. The impact of these factors represents a meaningful clinical difference in SRS-22 performance.

The treatment of vertebral and chest wall deformities with expandable thoracoplasty and a prosthetic expandable implant.

BACKGROUND: Expansion thoracoplasty is a temporary solution to allow complete pulomonary development in the setting of vertebral and rib cage deformities. After thoracoplasty, an expandable implant is needed to maintain the correction. The Growing Spine Profiler (GSP) is a new type of readjustable rib distracter. The purpose of this study was to evaluate the experiences of surgeons in Europe with the implantation of the GSP. METHODS: We retrospectively reviewed 44 patients that underwent placement of the GSP at 15 sites throughout Europe. The mean age at the time of surgery was 6.24 years. Basic demographic data and postoperative management were reviewed. All patients received an opening-wedge thoracostomy with device implantation and expansion thoracoplasty. Retrospectively, the original indications for implantation were determined. Digital images of the radiographs were used to measure coronal and sagittal parameters. RESULTS: The most common diagnoses for implantation were hemivertebrae (9), hemivertebrae with chest wall deformity (10), and unilateral bar (8). Outcomes were available for 43 patients with a mean follow-up period of 3.07 years. There were 23 patients that had an adverse event. Rib fractures were the most common adverse event, with 8 incidents in 7 patients. Radiographically, coronal curve magnitudes were maintained, whereas sagittal kyphosis gradually increased. CONCLUSIONS: The GSP was effective in the maintenance of deformity, while providing a moderate complication rate. Further studies need to be performed to determine the safety and efficacy of this implant.