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

Study Design: Cross-sectional. Objectives: To evaluate the perception and satisfaction among adolescent idiopathic scoliosis (AIS) patients on Neck Tilt with Medial Shoulder Imbalance and Lateral Shoulder Imbalance. Methods: Lenke 1 and 2 AIS patients were stratified into 6 groups of preoperative/ postoperative Balanced (B), Lateral Shoulder Imbalance (LSI) (>2 cm), and Neck Tilt with Medial Shoulder Imbalance (NT) (Grade 3). 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. Results: A total of 120 Lenke 1 and 2 AIS patients were recruited. NT patients were aware and unhappy with their abnormal neck with medial shoulder appearances (P < .001). Similarly, LSI patients were aware and unhappy with their abnormal lateral shoulder appearances (P < .001). NT group had larger preoperative/ postoperative T1 tilt (9.2 +/- 5.0 degrees; 9.5 +/- 5.3 degrees) and CA (4.6 +/- 3.1 degrees; 7.0 +/- 2.0 degrees) (P < .01). LSI group had larger preoperative/ postoperative Cla-A (4.8 +/- 2.8 degrees; 4.0 +/- 1.3 degrees) and RSH (20.1 +/- 9.4 mm; 17.0 +/- 6.6 mm) (P < .001). Postoperative 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 LSI scored the lowest comparatively (3.5 +/- 0.4; 2.4 +/- 0.5; 3.3 +/- 0.5) (P < .001). Conclusion: NT and LSI were major concerns among AIS patients. Both NT and LSI groups were unhappy with their appearances. NT group had larger T1 tilt/ CA whereas LSI group had larger Cla-A/ RSH. Postoperative B group scored higher in overall SRS-22r scores, self-image and satisfaction domains.

Automated summary

This cross-sectional study evaluated the perception and satisfaction of adolescent idiopathic scoliosis (AIS) patients with neck tilt and shoulder imbalance. The results showed that patients were aware of and unhappy with their abnormal appearances, and the overall satisfaction was higher postoperatively.