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Unexplained Post-Op Pain in Adolescent Scoliosis

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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.

“Study into causes of pain in AIS and whether preoperative education and expectations targeted at this population would positively impact outcomes is warranted, especially because, on average, patients after AIS surgery have less pain,” the authors write.

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