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Background <p>Adolescent idiopathic scoliosis (AIS) significantly impacts physical appearance and quality of life. This exploratory study aims to investigate potential association between cosmetic parameters and minimal clinical improvement in SRS-22r scores at a 2-year follow-up in AIS patients.</p> Methods <p>A total of 79 patients were included. Data, including the SRS-22r questionnaire and cosmetic parameters were systematically collected pre- and at 2-year follow-ups. Patients were divided into subgroups based on the Minimal Clinically Important Difference (MCID) values for different domains of the SRS-22r, including Total Improved (TI) and Non-Improved (TNI), Function Improved (FI) and Non-Improved (FNI), Self-image Improved (SI) and Non-Improved (SNI), Pain Improved (PI) and Non-Improved (PNI). Cosmetic corrections (<i>p</i> &lt; 0.05) were included in multivariate regression to explore potential associations with SRS-22r improvement.</p> Results <p>Significant differences in Medial Shoulder Tilt (MS), Lateral Shoulder Tilt (LS), Neck Angle (NA), Angle of Trunk Rotation (ATR), Scapula Asymmetry (SA), Waistline Depth Difference (WD), and Waistline Height Distance (WH) were observed pre- and postoperatively. The “TI” subgroup showed higher MS correction (1.63 ± 3.17°) than the “TNI” subgroup (0.38 ± 1.74°, <i>p</i> = 0.041). The “FI” subgroup showed greater ATR correction (4.82 ± 2.83°) than the “FNI” subgroup (2.82 ± 3.45°, <i>p</i> = 0.008). WD correction was higher in the “PI” subgroup (6.65 ± 8.58&#xa0;mm) than in the “PNI” subgroup (1.93 ± 5.95&#xa0;mm, <i>p</i> = 0.025). Logistic regression analysis suggested that, in this exploratory model, MS correction was associated with total domain improvement (OR = 1.240, <i>p</i> = 0.037), ATR correction was associated with function domian improvement (OR = 1.204, <i>p</i> = 0.022), and WD correction was associated with pain domain improvement (OR = 1.098, <i>p</i> = 0.017).</p> Conclusions <p>In addition to shoulder balance, spinal rotation and waistline asymmetry represent exploratory factors associated with SRS-22r improvement. These findings are hypothesis-generating, as the overall cohort did not achieve MCID thresholds; subgroup analyses explored responder characteristics rather than population-level efficacy.</p>

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Cosmetic parameters associated with SRS-22r improvement postoperatively in patients with adolescent idiopathic scoliosis: a 2-year follow-up

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  • 发表日期：

    2026年8月5日

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  • Aoran Maheshati,
  • Zhengye Zhao,
  • Xueyi Zhang,
  • Di Liu,
  • Guilin Chen,
  • Ziquan Li,
  • Kexin Xu,
  • Qing Li,
  • Baozhong Zhang,
  • Terry Jianguo Zhang,
  • Nan Wu

摘要

Background

Adolescent idiopathic scoliosis (AIS) significantly impacts physical appearance and quality of life. This exploratory study aims to investigate potential association between cosmetic parameters and minimal clinical improvement in SRS-22r scores at a 2-year follow-up in AIS patients.

Methods

A total of 79 patients were included. Data, including the SRS-22r questionnaire and cosmetic parameters were systematically collected pre- and at 2-year follow-ups. Patients were divided into subgroups based on the Minimal Clinically Important Difference (MCID) values for different domains of the SRS-22r, including Total Improved (TI) and Non-Improved (TNI), Function Improved (FI) and Non-Improved (FNI), Self-image Improved (SI) and Non-Improved (SNI), Pain Improved (PI) and Non-Improved (PNI). Cosmetic corrections (p < 0.05) were included in multivariate regression to explore potential associations with SRS-22r improvement.

Results

Significant differences in Medial Shoulder Tilt (MS), Lateral Shoulder Tilt (LS), Neck Angle (NA), Angle of Trunk Rotation (ATR), Scapula Asymmetry (SA), Waistline Depth Difference (WD), and Waistline Height Distance (WH) were observed pre- and postoperatively. The “TI” subgroup showed higher MS correction (1.63 ± 3.17°) than the “TNI” subgroup (0.38 ± 1.74°, p = 0.041). The “FI” subgroup showed greater ATR correction (4.82 ± 2.83°) than the “FNI” subgroup (2.82 ± 3.45°, p = 0.008). WD correction was higher in the “PI” subgroup (6.65 ± 8.58 mm) than in the “PNI” subgroup (1.93 ± 5.95 mm, p = 0.025). Logistic regression analysis suggested that, in this exploratory model, MS correction was associated with total domain improvement (OR = 1.240, p = 0.037), ATR correction was associated with function domian improvement (OR = 1.204, p = 0.022), and WD correction was associated with pain domain improvement (OR = 1.098, p = 0.017).

Conclusions

In addition to shoulder balance, spinal rotation and waistline asymmetry represent exploratory factors associated with SRS-22r improvement. These findings are hypothesis-generating, as the overall cohort did not achieve MCID thresholds; subgroup analyses explored responder characteristics rather than population-level efficacy.