Patients' Perception and Satisfaction on Neck and Shoulder Imbalance in Adolescent Idiopathic Scoliosis.

Abstract

Cross-sectional. To evaluate the perception and satisfaction among adolescent idiopathic scoliosis (AIS) patients on Neck Tilt with Medial Shoulder Imbalance and Lateral Shoulder Imbalance. Lenke 1 and 2 AIS patients were stratified into 6 groups of preoperative/ postoperative <i>Balanced (<b>B</b>), Lateral Shoulder Imbalance (<b>LSI</b>) (>2 cm),</i> and <i>Neck Tilt with Medial Shoulder Imbalance (<b>NT)</b> (Grade 3).</i> Patients were interviewed using Modified Neck and Shoulder Appearance and SRS-22r questionnaires. T1 tilt, Cervical Axis (CA), Clavicle Angle (Cla-A) and Radiographic Shoulder Height (RSH) were measured. A total of 120 Lenke 1 and 2 AIS patients were recruited. <b><i>NT</i></b> patients were aware and unhappy with their abnormal neck with medial shoulder appearances (<i>P</i> < .001). Similarly, <b><i>LSI</i></b> patients were aware and unhappy with their abnormal lateral shoulder appearances (<i>P</i> < .001). <i><b>NT</b></i> group had larger preoperative/ postoperative T1 tilt (9.2 ± 5.0°; 9.5 ± 5.3°) and CA (4.6 ± 3.1°; 7.0 ± 2.0°) (<i>P</i> < .01). <b><i>LSI</i></b> group had larger preoperative/ postoperative Cla-A (4.8 ± 2.8°; 4.0 ± 1.3°) and RSH (20.1 ± 9.4 mm; 17.0 ± 6.6 mm) (<i>P</i> < .001). Postoperative <b><i>B</i></b> group scored higher in overall SRS-22r scores, self-image and satisfaction domains (4.2 ± 0.3; 4.0 ± 0.5; 4.4 ± 0.5) while preoperative <b><i>LSI</i></b> scored the lowest comparatively (3.5 ± 0.4; 2.4 ± 0.5; 3.3 ± 0.5) (<i>P</i> < .001). NT and LSI were major concerns among AIS patients. Both <b><i>NT</i></b> and <b><i>LSI</i></b> groups were unhappy with their appearances. <b><i>NT</i></b> group had larger T1 tilt/ CA whereas <b><i>LSI</i></b> group had larger Cla-A/ RSH. Postoperative <b><i>B</i></b> group scored higher in overall SRS-22r scores, self-image and satisfaction domains.