Predictors of persistent postoperative pain after surgery for idiopathic scoliosis

Abstract

Purpose: To identify factors contributing to persistent postoperative pain in patients treated surgically for idiopathic scoliosis. Methods: In total, 280 patients aged ten through 25 years at surgery, were identified in the Swedish Spine registry; all having preoperative and postoperative visual analogue scale (VAS) for back pain scores. The patients were divided into a high and low postoperative pain group based on the reported postoperative VAS for back pain scores (by using 45 mm on the 0 mm to 100 mm VAS scale as a cut-off). The patient-reported questionnaire included VAS for back pain, the 3-level version of EuroQol 5-dimensional (EQ-5D-3L) instrument, the EuroQol VAS (EQ-VAS) and the Scoliosis Research Society 22r instrument (SRS-22r). Predictors of postoperative back pain were searched in the preoperative data. Results: The 67 (24%) patients that reported high postoperative VAS back pain (> 45 mm) also reported lower postoperative EQ-5D-3L, EQ-VAS and SRS-22r than patients with low postoperative VAS back pain (all p < 0.001). Two preoperative variables were independently associated with postoperative pain; each millimetre increase in preoperative VAS back pain (on the 0 mm to 100 mm scale) was associated with a higher risk of being in the high postoperative back pain group (odds ratio (OR) 1.03; 95% confidence interval (CI) 1.02 to 1.05) and each 1 point decrease on the preoperative SRS-22r mental health (scale from 1 to 5) was associated with a higher risk of being in the high postoperative back pain group (OR 1.68; 95% CI 1.03 to 2.73). Conclusion: High preoperative back pain and low preoperative mental health are independent predictors of back pain after surgery for idiopathic scoliosis. Level of Evidence: III

The Functional Outcome of Surgical Treatment of Adolescent Idiopathic Scoliosis

“…Rahma et al [24] found that the mean number of fused segments, the mean number of fused segments in our study was 14 ± 1.15 [range: [12][13][14][15][16][17]. In the Bullmann et al [28] series [combined], the number of fused segments was 11.2 ± 1.2 [range: [9][10][11][12][13]. Meanwhile, in the Li et al [29] series [combined], the mean number of fused segments was 13 [range: [10][11][12][13][14].…”

“…Additionally, the influence of the correction amount on functional outcomes of AIS is not well recognized. A weak correlation between curve of correction and functional outcomes was reported [4][5][6][7][8][9] . Also, another research showed a higher rate of complications after major corrections, comprising iatrogenic trunk imbalance [10] .…”

“…Also, another research showed a higher rate of complications after major corrections, comprising iatrogenic trunk imbalance [10] . But, the degree of correction after surgical intervention was a significant predictor of the functional scores, self-image/appearance and satisfaction [8][9][10][11][12].…”

Clinical Update on Patient-Controlled Analgesia for Acute Postoperative Pain

“…Predictors of postoperative pain and analgesic consumption have been assessed in several studies [6][7][8][9][10][11][12]. The severity of postoperative pain is multifactorial and complex [13].…”

The evolution of pre-operative SRS scores over time in patients with adolescent idiopathic scoliosis

“…Given that preoperative SRS scores have been closely linked to post-operative outcomes, it is especially important to have an understanding of how patients’ experience with scoliosis has evolved over time [ 7 , 8 ]. The purpose of this study was to determine if the AIS patients that surgeons treat today differ significantly from those patients treated in previous decades with respect to patients’ self-perception of their disease.…”