TY - JOUR
T1 - Preoperative SRS pain score is the primary predictor of postoperative pain after surgery for adolescent idiopathic scoliosis
T2 - an observational retrospective study of pain outcomes from a registry of 1744 patients with a mean follow-up of 3.4 years
AU - Harms Study Group
AU - Hwang, Steven W.
AU - Pendleton, Courtney
AU - Samdani, Amer F.
AU - Bastrom, Tracey P.
AU - Keeny, Heather
AU - Lonner, Baron S.
AU - Newton, Peter O.
AU - Buckland, Aaron
AU - Samdani, Amer
AU - Jain, Amit
AU - Lonner, Baron
AU - Roye, Benjamin
AU - Yaszay, Burt
AU - Reilly, Chris
AU - Hedequist, Daniel
AU - Sucato, Daniel
AU - Clements, David
AU - Miyanji, Firoz
AU - Shufflebarger, Harry
AU - Flynn, Jack
AU - Asghar, Jahangir
AU - Mac-Thiong, Jean Marc
AU - Pahys, Joshua M.
AU - Harms, Juergen
AU - Bachmann, Keith
AU - Lenke, Larry
AU - Abel, Mark
AU - Glotzbecker, Michael
AU - Kelly, Michael
AU - Vitale, Michael
AU - Marks, Michelle
AU - Gupta, Munish
AU - Fletcher, Nicholas
AU - Cahill, Patrick
AU - Sponseller, Paul
AU - Gabos, Peter
AU - Sturm, Peter
AU - Betz, Randal
AU - Lehman, Ron
AU - Parent, Stefan
AU - George, Stephen
AU - Hwang, Steven
AU - Shah, Suken
AU - Errico, Tom
AU - Upasani, Vidyadhar
N1 - Funding Information:
This study was supported in part by grants to the Setting Scoliosis Straight Foundation in support of Harms Study Group research from DePuy Synthes Spine, EOS Imaging, K2M, Medtronic, NuVasive, and Zimmer Biomet. Aaron Buckland, MD, New York University; Amer Samdani, MD, Shriners Hospitals for Children—Philadelphia; Amit Jain, MD, Johns Hopkins Hospital; Baron Lonner, MD, Mount Sinai Hospital; Benjamin Roye, MD, Columbia University; Burt Yaszay, MD, Rady Children’s Hospital; Chris Reilly, MD, BC Children’s Hospital; Daniel Hedequist, MD, Boston Children’s Hospital; Daniel Sucato, MD, Texas Scottish Rite Hospital; David Clements, MD, Cooper Bone & Joint Institute New Jersey; Firoz Miyanji, MD, BC Children’s Hospital; Harry Shufflebarger, MD, Nicklaus Children’s Hospital; Jack Flynn, MD, Children’s Hospital of Philadelphia; Jahangir Asghar, MD, Cantor Spine Institute; Jean Marc Mac-Thiong, MD, CHU Sainte-Justine; Joshua Pahys, MD, Shriners Hospitals for Children—Philadelphia; Juergen Harms, MD, Klinikum Karlsbad-Langensteinbach, Karlsbad; Keith Bachmann, MD, University of Virginia; Larry Lenke, MD, Columbia University; Mark Abel, MD, University of Virginia; Michael Glotzbecker, MD, Boston Children’s Hospital; Michael Kelly, MD, Washington University; Michael Vitale, MD, Columbia University; Michelle Marks, PT, MA; Setting Scoliosis Straight Foundation; Munish Gupta, MD, Washington University; Nicholas Fletcher, MD, Emory University; Patrick Cahill, MD, Children’s Hospital of Philadelphia; Paul Sponseller, MD, Johns Hopkins Hospital; Peter Gabos, MD: Nemours/Alfred I. duPont Hospital for Children; Peter Newton, MD, Rady Children’s Hospital; Peter Sturm, MD, Cincinnati Children’s Hospital; Randal Betz, MD, Institute for Spine & Scoliosis; Ron Lehman, MD, Columbia University; Stefan Parent, MD: CHU Sainte-Justine; Stephen George, MD, Nicklaus Children’s Hospital; Steven Hwang, MD, Shriners Hospitals for Children—Philadelphia; Suken Shah, MD, Nemours/Alfred I. duPont Hospital for Children; Tom Errico, MD, Nicklaus Children’s Hospital; Vidyadhar Upasani, MD, Rady Children’s Hospital.
Funding Information:
This study was supported in part by grants to the Setting Scoliosis Straight Foundation in support of Harms Study Group research from DePuy Synthes Spine, EOS Imaging, K2M, Medtronic, NuVasive, and Zimmer Biomet.
Funding Information:
S.W. Hwang has received consultancy fees and stock options from Auctus; consultancy fees and speaker honorarium from NuVasive; and speaker honorarium from Zimmer Biomet. A.F. Samdani has received consultancy fees from DePuy Synthes Spine; consultancy fees from Ethicon; consultancy fees from Globus Medical; consultancy fees and royalties from NuVasive; consultancy fees from Stryker; and consultancy fees and royalties from Zimmer Biomet. B.S. Lonner has received consultancy fees from ApiFix; consultancy fees, royalties, and speaker honorarium from DePuy Synthes Spine; consultancy fees Ethicon; research support from the John and Marcella Fox Fund; speaker honorarium from K2M; research support from OREF; stock/options from Paradigm Spine; stock/options from Spine Search; consultancy fees from Unyq Align; consultancy fees and royalties from Zimmer Biomet. P.O. Newton has received research support from Alphatec Spine; research support from DePuy Synthes Spine via the Setting Scoliosis Straight Foundation; royalties from DePuy Synthes Spine; stock/options from Electrocore; consultancy fees and research support from EOS Imaging; consultancy fees and royalties from K2M; research support from K2M via the Setting Scoliosis Straight Foundation; research support from MAZOR Surgical Technologies; research support from Medtronic via the Setting Scoliosis Straight Foundation; research support from NuVasive; research support from NuVasive via the Setting Scoliosis Straight Foundation; research support Orthopediatrics; research support Zimmer Biomet. Harms Study Group: Research grants to the Setting Scoliosis Straight Foundation in support of Harms Study Group research from DePuy Synthes Spine, EOS Imaging, K2M, Medtronic, NuVasive, and Zimmer Biomet. J.M. Pahys has received consultancy fees from DePuy Synthes Spine; consultancy fees from NuVasive; and consultancy fees from Zimmer Biomet. The other authors (C. Pendleton, T.P. Bastrom, H. Keeny) report no conflicts of interest.
Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Background: Traditionally, adolescent idiopathic scoliosis (AIS) has not been associated with back pain, but the increasing literature has linked varying factors between pain and AIS and suggested that it is likely underreported. Purpose: Our objective was to investigate factors associated with post-op pain in AIS. Methods: A prospectively collected multicenter registry was retrospectively queried. Pediatric patients with AIS having undergone a fusion with at least 2 years of follow-up were divided into two groups: (1) patients with a postoperative SRS pain score ≤ 3 or patients having a reported complication specifically of pain, and (2) patients with no pain. Patients with other complications associated with pain were excluded. Results: Of 1744 patients, 215 (12%) experienced back pain after postoperative recovery. A total of 1529 patients (88%) had no complaints of pain, and 171 patients (10%) had pain as a complication, with 44 (2%) having an SRS pain score ≤ 3. The mean time from date of surgery to the first complaint of back pain was 25.6 ± 21.6 months. In multivariate analysis, curve type (16% of Lenke 1 and 2 curves vs. 10% of Lenke 5 and 6, p = 0.002) and a low preoperative SRS pain score (no pain 4.15 ± 0.67 vs. pain 3.75 ± 0.79, p < 0.001) were significant. When comparing T2–4 as the upper instrumented vertebrae in a subgroup of Lenke 1 and 2 curves, 9% of patients had pain when fused to T2, 13% when fused to T3, and 18% when fused to T4 (p = 0.002). Conclusion: 12% of all AIS patients who underwent fusion had back pain after postoperative recovery. The most consistent predictive factor of increased postoperative pain across all curve types was a low preoperative SRS pain score. Graphic abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.]
AB - Background: Traditionally, adolescent idiopathic scoliosis (AIS) has not been associated with back pain, but the increasing literature has linked varying factors between pain and AIS and suggested that it is likely underreported. Purpose: Our objective was to investigate factors associated with post-op pain in AIS. Methods: A prospectively collected multicenter registry was retrospectively queried. Pediatric patients with AIS having undergone a fusion with at least 2 years of follow-up were divided into two groups: (1) patients with a postoperative SRS pain score ≤ 3 or patients having a reported complication specifically of pain, and (2) patients with no pain. Patients with other complications associated with pain were excluded. Results: Of 1744 patients, 215 (12%) experienced back pain after postoperative recovery. A total of 1529 patients (88%) had no complaints of pain, and 171 patients (10%) had pain as a complication, with 44 (2%) having an SRS pain score ≤ 3. The mean time from date of surgery to the first complaint of back pain was 25.6 ± 21.6 months. In multivariate analysis, curve type (16% of Lenke 1 and 2 curves vs. 10% of Lenke 5 and 6, p = 0.002) and a low preoperative SRS pain score (no pain 4.15 ± 0.67 vs. pain 3.75 ± 0.79, p < 0.001) were significant. When comparing T2–4 as the upper instrumented vertebrae in a subgroup of Lenke 1 and 2 curves, 9% of patients had pain when fused to T2, 13% when fused to T3, and 18% when fused to T4 (p = 0.002). Conclusion: 12% of all AIS patients who underwent fusion had back pain after postoperative recovery. The most consistent predictive factor of increased postoperative pain across all curve types was a low preoperative SRS pain score. Graphic abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.]
KW - Adolescent idiopathic scoliosis
KW - Pain
KW - Postoperative
KW - Prediction
KW - Preoperative
UR - http://www.scopus.com/inward/record.url?scp=85078455480&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85078455480&partnerID=8YFLogxK
U2 - 10.1007/s00586-020-06293-y
DO - 10.1007/s00586-020-06293-y
M3 - Article
C2 - 31993788
AN - SCOPUS:85078455480
SN - 0940-6719
VL - 29
SP - 754
EP - 760
JO - European Spine Journal
JF - European Spine Journal
IS - 4
ER -