Quality of Life (HRQoL) of AIS Patients Who Require Bracing or Surgery Using SRS-22 Questionnaire
Quality of Life (HRQoL) of AIS Patients Who Require Bracing or Surgery Using SRS-22 Questionnaire
Adolescent Idiopathic Scoliosis (AIS) is an unexpected curvature of spine at teenage. AIS
 causes mainly unpleasant appearance, and sometime comes with pain and difficult to locate or
 move around. When the spinal curve, or "Cobb angle", increases with time, the investigators
 call it severe condition when the Cobb angle is 60 degrees or above. The severe suffering
 patients need to be operated to correct their spinal curve by using metallic rods and
 metallic screws (implants) to fix the spine. In order to avoid this surgery, the
 investigators use "brace", a hard fitting case, trying to control the spinal curve degree by
 using forces from outside. (bracing) to intervene the spinal curve progression is highly
 recommended for patients with particular clinical characteristics. However, bracing is not
 always a present experience apart from function restriction. Clinical recommendation requires
 the patients to brace over 20 hours everyday, which means the patients have to be "braced"
 around the clock. Patients' perception on being "braced" all day, apart from discomforts
 under bracing, self-image and mental health after bracing are also important psycho-social
 factors which have yet to be addressed. Based on our clinical experience, 1-2% of AIS
 patients, undergoing bracing or not (i.e. at observation stage), require surgical
 intervention due to rapid spinal progression in a short period of time. By definition,
 surgery will be arranged for patients with major spinal curve ≥50. The use of
 health-related-quality-of-life (HRQoL) questionnaires allow clinical professionals to explore
 many different kinds of interests on patients, including the patient's feeling on his/her
 medical condition and satisfaction with provided care. Scoliosis Research Society (SRS)
 patient outcome tool has been a well-accepted HRQoL questionnaire to look for the perception
 of patients with spinal problems of their status. The SRS-22 questionnaire that has been well
 accepted as its trustworthy on the score results and SRS-22 is good to be used in patients
 under different conditions across the disease. This is very important to obtain and compare
 the scores over time in order to look for any consistent changes. Apart from AIS patients
 requiring bracing, surgical cases are also very important group of patients to monitor their
 quality of life before and after surgery, and every follow-up visit after surgery.
Adolescent Idiopathic Scoliosis (AIS) is a 3D deformity of spine happened with unidentifiable
 cause at teenage. AIS causes mainly cosmetic problems with a lesser incidence of functional
 deficit and pain. AIS patients under severe condition, defined as the major spinal curve
 angle named "Cobb angle" larger than 60 degrees, requires surgical intervention to the spinal
 curve with implants permanently applied along the spine. The use of "brace" (bracing) to
 intervene the spinal curve progression is highly recommended for patients with particular
 clinical characteristics. However, bracing is not always a present experience apart from
 function restriction. Clinical recommendation requires the patients to brace over 20 hours
 everyday, which means the patients have to be "braced" around the clock. Patients' perception
 on being "braced" all day, apart from discomforts under bracing, self-image and mental health
 after bracing are also important psycho-social factors which have yet to be addressed. Based
 on our clinical experience, 1-2% of AIS patients, undergoing bracing or not (i.e. at
 observation stage), require surgical intervention due to rapid spinal progression in a short
 period of time. By definition, surgery will be arranged for patients with major spinal curve
 ≥50 degrees.

 The health-related-quality-of-life (HRQoL) questionnaires allow clinical professionals to
 explore many areas of interest, including the patient's perception of his/her condition and
 satisfaction with provided care. Scoliosis Research Society (SRS) Outcomes Instrument has
 been an accepted HRQoL questionnaire to evaluate the perception of patients with spinal
 deformities of their status. The SRS-22 questionnaire that has been shown to have high
 reliability and concurrent validity and discrimination validity and responsiveness to change.
 SRS-22 questionnaire comprises 22 questions under 5 domains (function, pain, self-image,
 mental health, and satisfaction with management). Through these 22 questions, the
 psycho-social status can be quantified in terms of "scores" and the scores obtained at
 different time points can be compared. Continuous monitoring of these factors are important
 along the bracing period to look for patients with continuously poor psycho-social status of
 which bracing period is possibly last for years. Apart from AIS patients requiring bracing,
 surgical cases are also very important group of patients to monitor their quality of life
 before and after surgery, and every follow-up visit after surgery.
Inclusion Criteria:

 -  AIS patients who attend the scoliosis clinic at specialized outpatient clinic in
 Prince of Wales hospital and require wearing brace, or patients who suffer from severe
 scoliosis and require surgery on their first clinic visit

 -  Can read and understand either English or Chinese

 Exclusion Criteria:

 -  To observe (i.e. not require to wear brace) after clinic visit

 -  Cannot read or understand either English or Chinese