Decrease of self-concept in adolescent patients with mild to moderate scoliosis after conservative treatment.

STUDY DESIGN: Comparative study.

OBJECTIVE: To analyze the effect of conservative treatment on self-concept in patients with mild to moderate scoliosis.

SUMMARY OF BACKGROUND DATA: The choice of surgery or conservative treatment in adolescent idiopathic scoliosis is usually done on the basis of the magnitude of the initial Cobb angle in these patients. However, mental effect of the therapy choice should be considered.

METHODS: Between August 2006 and December 2008, 65 patients with adolescent idiopathic scoliosis were selected for this study. Twenty-two patients with Cobb angles between 20° and 40° received conservative treatment, 18 patients with Cobb angles between 40° and 50° received conservative treatment, and 25 patients with Cobb angles between 40° and 50° received surgical treatment. All subjects were required to fill the Children's Self-Concept Scale at the beginning of the study and at the follow-up visit 1 year later. Scores on this scale were compared among the three different groups, and between the initial visit and the follow-up visit in each group.

RESULTS: At the initial test, the total self-concept score was significantly higher in the group of patients with Cobb angles between 20° and 40° than in the two groups with Cobb angles between 40° and 50°. At the follow-up visit, the total self-concept score had increased significantly in the surgically treated group (Cobb angle between 40° and 50°), however, it had decreased in the two conservatively treated groups. No significant difference was seen between the two conservatively treated groups in the amount by which the self-concept score had decreased at follow-up.

CONCLUSION: In terms of mental health, conservative treatment is not ideal for patients with mild to moderate scoliosis, and in particular, it is not conducive to mental health in patients with Cobb angles between 40° and 50°.