Correlation of Photogrammetric Trunk Asymmetry Indices (ATSI, POTSI) with Self-Perceived Spinal Appearance in Adolescents with Idiopathic Scoliosis.

Adolescent Idiopathic Scoliosis (AIS) impacts both trunk morphology and body image. While the Cobb angle and photogrammetric metrics (ATSI, POTSI) objectively measure physical deformity, they may not reflect the patient's subjective perception. This study investigated the correlation between these objective indices and self-perceived appearance using the Spinal Appearance Questionnaire (SAQ). A retrospective observational study included 30 female adolescents with AIS (mean age 14.47 ± 1.90 years; Cobb >10°). Trunk asymmetry was objectively evaluated via photogrammetric calculation of ATSI and POTSI scores. Subjective perception was assessed using the Greek version of SAQ. Spearman's rank correlations were used to analyze relationships between the objective indices and SAQ scores. Participants had a mean Cobb angle of 30.77° ± 9.51° and a mean SAQ Total score of 52.07 ± 7.98. The analysis revealed no statistically significant correlations between the total SAQ score and ATSI (r = -0.014, p = 0.943), POTSI (r = 0.113, p = 0.552), or the Cobb angle (r = 0.049, p = 0.796). Objective measures of trunk deformity, both radiographic and photogrammetric, do not correlate with self-perceived spinal appearance in adolescents with AIS. This highlights that body image is a multidimensional construct distinct from physical severity, necessitating the routine clinical use of Patient-Reported Outcome Measures (PROMs) alongside objective parameters.