Busra Nur Ozcan Erisgin, Bedirhan Albayrak, Altan Aksu, Ahmet Uzun, Huseyin Sina Coskun
Journal of Turkish Spinal Surgery - 2026;37(2):76-81
Objective: Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity that may negatively affect adolescents' psychosocial well-being. Increasing evidence suggests that radiographic severity alone does not fully explain the impact of scoliosis on health-related quality of life (HRQoL). However, the extent to which curve magnitude and location influence domain-specific HRQoL outcomes remains unclear. Materials and Methods: This cross-sectional study included 65 adolescents with AIS who were evaluated at a university hospital outpatient clinic. Participants completed the validated Turkish version of the scoliosis research society-22 (SRS-22) questionnaire. Standing posteroanterior full-spine radiographs were used to determine Cobb angle, curve location (proximal thoracic, main thoracic, thoracolumbar/lumbar), and Risser stage. Differences among SRS-22 domains were assessed using the Friedman test, followed by Bonferroni-corrected Wilcoxon signed-rank tests. Comparisons between curve location groups were performed using the Kruskal-Wallis test. Associations between curve magnitude and SRS-22 domain scores were assessed using Spearman correlation. Results: Self-image and mental health were the most adversely affected SRS-22 domains, whereas pain and functional activity scores were relatively preserved [Friedman chi2(4)=78.18, p<0.001]. No significant differences in SRS-22 total or domain scores were observed across curve location groups (all p>0.05). Spearman correlation analysis demonstrated no significant associations between Cobb angle magnitude and any SRS-22 domain. Conclusion: Psychosocial domains, particularly self-image and mental health, constitute the primary burden in AIS and appear largely independent of radiographic severity and the curve pattern. These findings support a patient-centered approach to AIS management that incorporates psychosocial assessment alongside conventional radiographic evaluation.
