Improvement in SRS22R Pain Scores after Surgery for Adolescent Idiopathic Scoliosis

Mladen Djurasovic, Steven D. Glassman, Daniel J. Sucato, Lawrence G. Lenke, Charles H. Crawford, Leah Y. Carreon

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

STUDY DESIGN.: Longitudinal cohort. OBJECTIVE.: To investigate whether patients with painful adolescent idiopathic scoliosis experience pain relief with surgical treatment. SUMMARY OF BACKGROUND DATA.: Adolescent idiopathic scoliosis (AIS) was previously thought to be a painless condition, but recent studies have shown that a significant proportion of patients have pain. Little information is available regarding pain relief with surgical treatment for AIS. METHODS.: Patients enrolled in a prospective database of surgically treated AIS were divided into two groups based on their preoperative SRS22R pain domain score. Patients with a preoperative pain domain score of ≥ 4 (N?=?1005) were classified as non-painful. If the preoperative pain domain score was < 4 (N?=?505), they were classified as painful. Demographics, SRS total and domain scores, as well as changes with treatment were compared for the two groups. RESULTS.: The two groups had similar demographics and pre-op coronal curve magnitude. Patients with painful scoliosis experienced significant improvement in SRS22R pain scores, from 3.29 preoperatively to 4.03 postoperatively (p?<?0.000). 81% of these patients reached the MCID threshold (0.20) for improvement in pain score. Painful scoliosis patients also had greater two-year improvement in Total and all domain scores than the non-painful scoliosis patients (p?<?0.000). Absolute values of SRS22R Total and domain scores were all greater at two-years in the non-painful group than the painful group. CONCLUSIONS.: AIS patients with substantial back pain can be cautiously counseled to expect significant improvement in pain level with surgical correction of their deformity, even if curve progression is the primary indication for surgery. Although these patients achieve greater improvements in health-related quality of life compared to patients with mild or no pain, two-year SRS22R scores were still better in patients with mild or no pain preoperatively. LEVEL OF EVIDENCE.: 2

Original languageEnglish (US)
JournalSpine
DOIs
StateAccepted/In press - Nov 15 2016

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

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