Aesthetic appearance assessment in adolescents with idiopathic scoliosis

Introduction. Aesthetic appearance is one of the major concerns in adolescent idiopathic scoliosis (AIS) patients and its improvement is one of the main treatment's goals. Poor trunk appearance is associated with reduced quality of life in adolescents with idiopathic scoliosis. Aim. To review instruments that have been created to evaluate poor trunk appearance in these children. Material and methods. PubMed database and the Consortium of Libraries of Serbia for Unified Acquisition - KoBSON were searched using the keywords "adolescent scoliosis", "aesthetic appearance", "evaluation" and "questionnaires". Results. In order to evaluate the aesthetic impairment in these patients, various instruments have been created. They can roughly be classed as instruments that assess subjective perception or objective aesthetic appearance. The first group consists primarily of self-administered quality of life questionnaires that include an aesthetic component, such as the Scoliosis Research Society 22 (SRS-22) questionnaire and the Italian Spinal Youth Quality of Life (ISYQoL) questionnaire, as well as visual scales based on patient-completed trunk drawings, such as the Walter Reed Assessment Scale, the Spinal Appearance Questionnaire, and the Trunk Appearance Perception Scale. Trunk asymmetry scales that use pictures, such as the TRACE (Trunk Aestethic Clinical Evaluation), the POTSI (Posterior Trunk Symmetry Index) and the ATSI (Anterior Trunk Symmetry Index), 2-dimensional digital photography, and surface topography can all be used to assess the aesthetic profile of subjects, allowing for objective evaluation. Conclusion. Each clinical examination should include a specific assessment of trunk asymmetry. Various instruments were developed with the goal of decreasing x-ray radiation exposure in these patients.