Impact of non-surgical factors on treatment results of patients with idiopathic scoliosis according to SRS-22 data (systematic review)
Authors: Molotkov Yu. V. , Evsyukov A. V. , Ryabykh S. O. , Savin D. M. 
Published: August 2024

Introduction Idiopathic scoliosis is characterized by a multicomponent deformity of the axial skeleton, surgical correction of which is advisable to improve the quality of life of patients. The SRS-22 questionnaire is widely used for its evaluation.

The purpose of the work was to identify and evaluate, using a systematic review method, non-surgical, socio-economic and other factors not directly related to surgical intervention that influence the results of SRS-22.

Materials and methods The search was performed on the PubMed electronic platform in accordance with the PICOS protocol. Initially, 280 articles were selected for the period of 2003-2023. The authors carried out further selection manually. The review was based on the analysis of 15 articles containing data to determine the influence of various factors on the results of the SRS-22 questionnaire.

Results It was revealed that the results of SRS-22 depend on many factors that are not directly related to either the spinal pathology itself or its surgical treatment. Contemporary studies assessing quality of life in scoliosis emphasize the influence of ethnic and socioeconomic factors on the results of the SRS-22 survey.

The results indicate differences in the assessment of the quality of life of patients with comparable pathologies depending on the geographical and social context. The role of three-way interaction between the doctor, parents and paediatric patient when assessing the results of the SRS-22 survey was considered. It was found that SRS-22 scores before and after the initial medical consultation did not have significant differences; and the assessment by parents did not differ from the assessment by the paediatric patient. A relationship was found between the use of “rigid” functional corrective braces and the results of SRS-22 — indicators of satisfaction with treatment, and, accordingly, the overall SRS-22 score in patients who received brace therapy were significantly higher. It was found that physical activity and endurance correlate with the quality of life of patients with idiopathic scoliosis.

Discussion The SRS-22 questionnaire is a key tool for assessing the quality of life of patients with scoliosis, taking into account their age and functional status. Over the years of using SRS questionnaires, various scientists have proposed several modifications to improve accuracy and ease of use, but only SRS-22 has become generally accepted. It is necessary to develop special additional algorithms that allow the results of various versions of SRS questionnaires to be interpreted into a single format for their analysis and comparison.

Conclusion The relationship and influence of the severity and structure of spinal deformity on the standard of living is an extremely heterogeneous and multicomponent issue. SRS-22 results are strongly influenced not only by medical factors, but also by age, ethnic, cultural, social and economic factors. There is a gradual change in SRS-22 scores in the postoperative period over decades since the moment of surgery. Parents are quite accurate in assessing their child's condition when using the SRS-22.