Scoliosis research society-22 results in 3052 healthy adolescents aged 10 to 19 Years

Michael D. Daubs*, Man Hung, Ashley Neese, Shirley D. Hon, Brandon D. Lawrence, Alpesh A. Patel, Prokopis Annis, John Smith, Darrel S. Brodke

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

32 Scopus citations


STUDY DESIGN.: Cross-sectional survey. OBJECTIVE.: The purpose of our study was to evaluate a large population of adolescents from a broad mix of racial/ethnic backgrounds and age groups to better establish baseline normative values for the Scoliosis Research Society-22 (SRS-22). SUMMARY OF BACKGROUND DATA.: The SRS-22 instrument was developed to assess treatment outcomes in patients with adolescent idiopathic scoliosis. To accurately assess real changes in outcome measures, the SRS-22 must be able to differentiate patients with and without adolescent idiopathic scoliosis. METHODS.: The SRS-22 was administered to 3052 healthy adolescents, 51% female and 49% male, with a mean age of 14.6 years (range, 10-19 yr). We grouped the children into 3 age groups for analysis: 10 to 12 years (362), 13 to 15 years (1487), and 16 to 19 years (1203). Racial/ethnic groups included: Caucasian, 62%; African American, 14%; Hispanic, 9%; Asian, 6%; Native American, 5%; and Pacific Islander, 4%. SRS-22 scores were analyzed to establish normative values for each group. RESULTS.: Mean SRS-22 scores were: activity, (4.31 ± 0.54); pain, (4.44 ± 0.67); image, (4.41 ± 0.64); mental, (3.96 ± 0.81); and total, (4.26 ± 0.54). Females had lower scores in the mental domain (3.90) than males (4.04) (P < 0.001). The scores of children aged 10 through 12 years were higher in the domains of activity (P = 0.000), pain (P < 0.001), and mental (P < 0.001) than those of children aged 13 through 15 years and 16 through 19 years. The 13- to 15-year group had significantly higher scores than the 16- to 19-year group (P < 0.001) in each of the same categories. Regarding race/ethnicity, Caucasians tended to report higher scores in most domains than other race/ethnic groups. Hispanics scored lower in all domains than the non-Hispanic group. CONCLUSION.: Age, sex, and race had a significant impact on SRS-22 scores in a large group of healthy adolescents. In general, scores lowered as age increased from 10 to 19 years, Caucasians scored higher in function, pain, and image than other racial groups, and Hispanics scored lower than non-Hispanics in all domains. These factors should be considered when evaluating SRS-22 scores.Level of Evidence: 3

Original languageEnglish (US)
Pages (from-to)826-832
Number of pages7
Issue number10
StatePublished - May 1 2014


  • Scoliosis Research Society (SRS)-22 validation
  • adolescent idiopathic scoliosis
  • demographics
  • health related quality of life measures
  • patient-reported outcomes

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine


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