Culture and Ethnicity Influence Outcomes of the Scoliosis Research Society Instrument in Adolescent Idiopathic Scoliosis.

By London Spine

Culture and Ethnicity Influence Outcomes of the Scoliosis Research Society Instrument in Adolescent Idiopathic Scoliosis.

Spine (Phila Pa 1976). 2011 Nov 8;

Authors: Morse LJ, Kawakami N, Lenke LG, Sucato DJ, Sanders JO, Diab M

Abstract
STRUCTURED ABSTRACT: Study Design. Retrospective comparative studyObjective. To report pre-operative differences in the Scoliosis Research Society Outcomes Instrument (SRS-30) between multiple United States ethnicities, and native Japanese and Korean children with adolescent idiopathic scoliosis (AIS).Summary of Background Data. The SRS-24 was developed in a United States cohort with AIS. Comparative studies using the SRS-24 between United States and Japanese patients showed differences suggesting culture may affect functional outcome.Methods. Pre-operative SRS-30 outcomes were collected from 1853 children with AIS from 6 different ethnic groups: United States White (1234), Black (213), Hispanic (78), and Asian (29), as well as native Japanese (192) and Koreans (107). Analysis of covariance of 4 SRS-30 domains (pain, appearance, activity, and mental) was compared between groups adjusting for differences in age, gender, major curve magnitude, and body mass index. Pair-wise comparisons of the 4 SRS-30 domains were adjusted for multiple comparisons using Bonferroni correction. A p-value of <0.05 was considered significant.Results. Significant differences between ethnicities were found in all domains (p < 0.001). Whites reported more pain than Japanese or Koreans (Japanese 4.52, Korean 4.47, White 4.04). Korean and Japanese patients had the lowest appearance scores (Japanese 2.89, Korean 2.73, US Asian 3.55, Hispanic 3.11, Black 3.47, White 3.29). Koreans also had the lowest activity (Korean 3.64, Japanese 4.24, US Asian 4.07, Hispanic 4.02, Black 4.06, White 4.16), mental (Korean 3.70, Japanese 4.23, US Asian 4.05, Hispanic 3.75, Black 4.03, White 3.94), and total scores (Korean 3.63, Japanese 3.92, US Asian 4.02, Hispanic 3.75, Black 3.92, and White 3.84).Conclusion. Culture and ethnicity influence SRS-30 outcomes in AIS. Whites reported more pain than Japanese and Koreans. Japanese and Koreans had the lowest appearance scores. Koreans additionally were distinguished by the lowest activity, mental, and total scores. These cultural and ethnic differences must be taken into account when counseling patients with AIS, and studying functional outcomes.

PMID: 22076648 [PubMed – as supplied by publisher]