Pain Trajectories Following Adolescent Idiopathic Scoliosis Correction: Analysis of Predictors and Functional Outcomes

Overview

Journal JB JS Open Access

Date 2021 May 31

PMID 34056507

Citations 12

Authors

Kristen M Bailey

Jason J Howard

Ron El-Hawary

Jill Chorney

Affiliations

Soon will be listed here.

Abstract

Background: A better understanding of early pain trajectories (patterns) following scoliosis surgery and how they relate to baseline patient characteristics and functional outcomes may allow for the development of mitigating strategies to improve patient outcomes.

Methods: This was a prospective cohort study. Adolescents with idiopathic scoliosis were recruited across multiple centers. Latent growth mixture modeling techniques were used to determine pain trajectories over the first postoperative year.

Results: The median numerical rating scale for pain in the hospital following surgery for adolescent idiopathic scoliosis was 5.0. It improved to 1.0 by 6 weeks, and was maintained at <1 by 3 to 12 months postoperatively. Three trajectories were identified, 2 of which involved moderate acute postoperative pain: 1 with good resolution and 1 with incomplete resolution by 1 year. The third trajectory involved mild acute postoperative pain with good resolution by 1 year. Membership in the "moderate pain with incomplete resolution" trajectory was predicted by higher baseline pain and anxiety, and patients in this trajectory reported worse quality of life than those in the trajectories with good resolution.

Conclusions: Pain recovery following surgery for idiopathic scoliosis was found to be substantial during the first 6 weeks and continued up to 1 year. We identified 3 main trajectories, 2 with favorable outcomes and 1 with persistent pain and worse quality of life at 1 year postoperatively. The risk factors most associated with the latter trajectory included increased baseline pain and anxiety.

Level Of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Citing Articles

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