Adaptation of the Scoliosis Research Society–22 Questionnaire for the Hebrew Language: Transcultural Adaptation and Reliability Analysis

Study Design: A cross-cultural adaptation and reliability study. Objective: To perform cross-cultural adaptation and evaluate the reliability and validity of the Hebrew version of the Scoliosis Research Society–22 (SRS-22) questionnaire. Summary of Background Data: The SRS-22 validated in different languages is used in assessing health-related quality of life of patients with scoliosis. Methods: The English SRS-22 was translated/retranslated and a cross-cultural adaptation was performed. The Hebrew SRS-22 was administered twice, a week apart, to 45 patients with idiopathic scoliosis and 15 with Scheuermann kyphosis. The Cobb angle of the thoracic curvature, the numeric rating scale (NRS) of pain and of the self-perceived cosmetic defect, were evaluated. Internal consistency was determined by the Cronbach α coefficient. Intraclass correlation was used for test-retest reliability. Concurrent validity of the SRS-22 domains with the Cobb angle, NRS pain, and NRS cosmetic defect was evaluated by Pearson correlation. Results: The mean age of the subjects was 17.3 ± 7.42 years. The Cobb angle was 39.43 ± 17.52, NRS pain during the last 24 hours was 4.35 ± 3.42, and the NRS cosmetic defect was 3.80 ± 3.57. The mean overall Cronbach α of the Hebrew SRS-22 was 0.75. Two domains, function/activity (α = 0.63) and satisfaction (α = 0.66), showed a questionable internal consistency, self-image (α = 0.72) showed acceptable, pain (α = 0.80) good, and mental health (α = 0.92) excellent internal consistency. The intraclass correlation for five domains ranged from 0.71 to 0.95, demonstrating good test-retest reproducibility. The concurrent validity of the SRS-22 in scoliosis subjects with the Cobb angle was moderate (r = 0.37), and with NRS pain (r = 0.62) and NRS cosmetic defect (r = 0.54) good. In kyphosis subjects, the only significant high correlation was found between the self-image domain of SRS-22 and the NRS cosmetic defect (r = 0.84). Conclusion: The Hebrew version of the SRS-22 can be used to assess the outcome of treatment among Hebrew-speaking patients with idiopathic scoliosis and Scheuermann disease. Level of Evidence: Level 2.