Waistline asymmetry is most affects self-image in patients with adolescent idiopathic scoliosis

<p>Introduction: The waistline asymmetry (WLA) is an important cosmetic concern in adolescent idiopathic scoliosis (AIS). However, radiological evaluating of WLA is not well established, and there is few evidence that the patient perception relates to actual WLA. Therefore, the present study aimed to investigate the relationship between torso asymmetry including WLA and SRS-22 self-image domain in AIS patients.</p><p>Methods: We retrospectively reviewed 32 AIS girls who underwent surgery between 2013 and 2019. We obtained the SRS-22 self-image score and the standing posteroanterior whole spine radiograph before and 1 year after surgery. On radiographs, waist height index (WHI), right/left waist angles ratio (WAR) and right/left waist distance index (WDI) were measured for evaluation of WLA. In addition, radiographic shoulder height, thoracic trunk shift, and coronal balance were also obtained. The correlation between there deformity parameters and the SRS-22 self-image score were investigated by multivariate analysis.</p><p>Results: The SRS-22 self-image score and deformity parameters other than coronal balance were significantly improved after surgery. In multiple regression analysis, WHI, WAR, and WDI were extracted as factors significantly related to the SRS-22 self-image score. From linear regression analysis, the SRS-22 self-image score could be predicted by the equation (self-image score = 93.7−0.41×｜WHI｜−0.65×｜WDI｜−0.76×｜WAR｜).</p><p>Conclusions: WLA was evaluated by WHI, WAR and WDI. WLA was significantly associated with the SRS-22 self-image score. Normalizing WLA is important for improving the self-image of the AIS patients.</p>