Patients’ Perceptions of Breast Asymmetry Improve After Spinal Fusion for Adolescent Idiopathic Scoliosis

Rudo Duri, Kaitlyn Brown, Megan Johnson, Amy McIntosh

Research output: Contribution to journalArticle

3 Scopus citations


Study Design: Adolescent idiopathic scoliosis (AIS) patients undergoing spine fusion (SF) had their data prospectively collected. The SRS Spine Appearance Questionnaire (SAQ) was the primary outcome measure. The data were reviewed in a retrospective manner. Objectives: Patient concerns about breast/chest wall asymmetry in AIS is high. This study sought to determine the improvement after spinal fusion (SF). Breast/chest wall asymmetry is a significant physical deformity associated with AIS. No literature exists on patient satisfaction related to improved breast/chest wall appearance after SF surgery. Methods: 474 patients undergoing SF for AIS from 2006 to 2014 completed the SRS SAQ preoperation and at two years postoperation. Data were prospectively collected and reviewed in a retrospective manner. The SAQ includes two statements regarding breast/chest wall asymmetry (19 and 20). Statistical analysis was performed to determine a relationship between improved SAQ responses and any clinical/radiographic or surgical parameters. Results: 395 females and 79 males (14.4 ± 2.0 years) with preoperation and two-year postoperation Cobb angle 60.6 ± 11.5 and 26.6 ± 12.1 were reviewed. Before surgery, 68.0% of patients identified with the statement “I want to have more even breasts” compared with 37.0% at two years postoperation. In addition, 78.9% identified with the statement “I want to have a more even chest in the front” preoperatively compared with 34.0% at two years postoperation. Positive preoperative responses correlated with scoliometer (p = .029) (p = .044) and Cobb angle of the major curve (p = .048 and p = .006). At two years postoperation, there was a significant number of patients (76%) who had at least a two-point decrease in their response to either statement (p < .0001). Conclusion: Breast asymmetry is a significant concern of many AIS patients, including males, and correlates with preoperative curve magnitude. SF results in significant improvement in patient perception of breast/chest wall asymmetry, with 76% of patients reporting good outcomes at two years postoperation. Level of Evidence: Level 2.

Original languageEnglish (US)
JournalSpine Deformity
StateAccepted/In press - Jan 1 2018


  • Adolescent idiopathic scoliosis
  • Breast asymmetry
  • Self perception
  • Spinal fusion

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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