Treatment of Idiopathic Scoliosis During Adolescence: A Qualitative and Quantitative Analysis of Its Long-Term Psychosocial and Functional Impact

Purpose: No prior study could be identified that combined qualitative and quantitative methods to analyse the long-term psychosocial and functional state of Idiopathic Scoliosis (IS) patients treated during adolescence. This study aimed to better understand these patients' long-term health status by identifying key factors that had influenced it over time. Methods: A mixed-methods approach was used. Qualitative data included recording, transcription, coding and content analysis of focus groups and semi-structured interviews. For the quantitative analysis, patients completed questionnaires. Results: Fifty-seven patients were recruited. Two focus groups and 44 individual interviews were performed. All of them completed the questionnaires. Quantitative analyses showed significant age-related differences in ODI, SRS22-Function, SRS22-Pain, SRS22-Self Image and trunk deformity perception, with older patients showing poorer results. Trunk deformity perception was the only domain associated with treatment received, with conservative patients scoring worse. Qualitative findings highlighted psychosocial impacts of IS and its treatments during adolescence, particularly related to bracing, which was often associated with discomfort and social stigma. However, these effects generally did not persist into adulthood. In contrast, surgical treatment was generally viewed positively, associated with deformity correction, improved self-image and the elimination of bracing, all contributing to better social integration and overall well-being. Qualitative factors influencing current self-image, self-esteem and overall well-being varied by both age and treatment type. Conclusions: While IS may significantly impact adolescents’ psychosocial health, particularly when it is treated with bracing, the effect tends not to persist into adulthood. In adulthood, age becomes the primary determinant of psychosocial health and general well-being. This mixed-method approach revealed distinct factors influencing each domain studied and offered a deeper understanding of their interconnections, highlighting the complex interplay between social, physical, and psychological factors. These findings underscore the importance of a holistic, patient-centered approach in managing IS, with greater emphasis on psychosocial aspects including self-image, self-esteem, and sexual health, throughout treatment planning and long-term follow-up.