Preliminary study comparing parent and child functioning by intervention for adolescent idiopathic scoliosis

OBJECTIVE: The purpose of this study is to assess whether there are significant differences between pre-surgical and bracing patients with Adolescent Idiopathic Scoliosis (AIS) in parent and child functioning including pre-operative pain, pre-operative anxiety, parent pain catastrophizing, and parent protectiveness over child's pain symptoms. METHODS: Eligible patients were recruited from the Boston Children's Hospital Orthopedics Department. Retrospective chart reviews were conducted to identify patients aged ten through seventeen with AIS who were recommended for brace treatment or spinal fusion surgery. The study included thirty-five participants and their parents, seventeen pre-surgical participants and eighteen bracing participants. REDcap questionnaires were sent to parents and their children to fill out. The questionnaires included the following measures of interest for this study: Adult Responses to Children's Symptoms (ARCS), the Pain Catastrophizing Scale (PCS), the Multidimensional Anxiety Scale for Children (MASC), and the Numeric Rating Scale (NRS) for pain. One-way ANOVAs were used to determine if there were statistically significant differences between the two groups on the following variables: age and sex of the child, sex of the parent, race and ethnicity of the parent and child, degree of curvature of the spine (Cobb angle), and on the above mentioned parent and child measures. RESULTS: The group demographics were representative of the typical AIS population. Significant differences in age, Cobb angle, and sex of the child were determined between groups and represent potential confounding factors. There was a significant difference between groups for PCS magnification and a trend towards significance for PCS helplessness and the total PCS score. Other measure differences were statistically insignificant. CONCLUSIONS: Potential differences in parent and child measures were assessed to investigate parent and child functioning in the context of two medical interventions used to treat AIS. Bracing treatment and spinal fusion surgery were chosen with the intent to determine if the severity of an intervention has adverse effects on parent and child functioning. It is important to consider these results in a preliminary context due to the small sample size. Nonetheless, the results suggest that pre-surgical patients and their families are affected differently by the additional stressors and life-altering factors that come with spinal fusion surgery. There seems to be greater emphasis placed on their child's pain as well as a sense of helplessness. Both factors may have adverse effects on their child's ability to cope with the stress of surgery, which may also translate into a more difficult recovery period