Adolescent scoliosis: Effects of corrective surgery, cognitive-behavioral interventions, and age on activity outcomes

The effects of spinal fusion surgery and cognitive-behavioral interventions on 88 adolescents' (11-18 years) activity outcomes were examined using a randomized trial with three intervention groups (information only, coping only, coping plus information) and a control group. The effects included a significant drop from baseline (preoperative) in usual activities and social activities at 1 month postsurgery for all groups, indicating that initially postsurgical recovery is particularly disruptive to patients' lives. At 3 months after surgery, all groups showed increased usual activities and social activities. Between the 3- and 6-month assessments, all groups had increases in social activities. Furthermore, the information only group had a significant increase in usual activities from 3 to 6 months. Younger adolescents (ages 11-14) in the combined information plus coping group and the control group had higher social scores over the postsurgery recovery period compared with those in the coping-only group. No differences were found on academic performance. The adolescents did not return to their baseline social activity levels during the 9-month recovery period (typically when long-term recovery is completed), indicating that the surgery itself has a long-term negative effect on patients' social life.