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12 October 2013

Unexplained Post-Op Pain in Adolescent Scoliosis Cases

Unexplained pain after the six-month postoperative period occurs in 7% of patients undergoing surgery for adolescent idiopathic scoliosis (AIS), according to a study published in the Oct. 1 issue of Spine.

Tracey P. Bastrom, from Rady Children's Hospital in San Diego, and colleagues reviewed data from a prospective registry to identify AIS surgical patients with minimum two-year follow-up and two-year Scoliosis Research Society (SRS) scores. Results from the SRS-22 outcomes questionnaire were compared for patients reporting pain or not to the surgeon/clinical team postoperatively.

The researchers found that, of the 584 eligible patients, 11% reported pain at sometime between two weeks and two years postoperatively. Of the 48 patients reporting pain between six and 24 months postoperatively, 41 (7% of the total cohort) had no obvious cause for their pain. They also had significantly decreased two-year SRS scores in the domains of Pain, Self-Image, Mental Health, and Total score despite referral for physical therapy, a pain specialist, or further imaging in 26 of the 41 cases. There was significantly greater pain preoperatively in the patients with postoperative pain, so for this group the pre- to postoperative SRS pain scores did not significantly change.