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Back Pain and Its Change After Surgery in Adolescents and Young Adults With Idiopathic Scoliosis

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Abstract

Study Design

A retrospective analysis of prospectively collected data from patients aged 12–30 years, operated for AIS in our hospital from 2005 to 2014 and registered in our local patient outcomes database linked to EUROSPSINE’s Spine Tango Registry.

Objectives

To investigate whether in patients with AIS and notable back pain surgery is associated with significant pain relief and whether age influences outcome.

Summary of Background Data

Few studies have investigated the association between adolescent idiopathic scoliosis and back pain and the influence of age on the relief of back pain after surgical correction of the deformity.

Methods

Preoperatively and up to two years’ postoperatively, patients completed the Core Outcome Measures Index, which includes two 0–10 scales for back pain and leg/buttock pain. A score of 4/10 or more is considered “relevant pain.”

Results

We identified 85 patients with AIS (74 (87%) females) in the database; 60 were aged 12–18 years (mean 15.5 ± 1.7 years) and 25 were 19–30 years (mean 22.5 ± 3.1 years). There were no significant differences (p > .05) between the age groups for coronal Cobb angles of the main curves or Lenke curve types, and these curves showed no correlation with pain intensity (p > .05). Back pain was correlated with age (r = 0.31, p = .004). Preoperatively, 42% patients had a back pain score of ≥4/10 (52% in adults, 38% in adolescents). Just 8% patients had a leg pain score of ≥4/10 (16% in adults, 5% in adolescents). Those with notable back pain showed a significant (p < .0001) improvement two years after surgery. However, 24% of patients with no back pain at baseline showed a worsening of pain by 2 (out of 10) points or more two years postoperatively. There was no significant difference in the extent of improvement in older and younger patients (p = .22).

Conclusion

In patients undergoing surgery for correction of AIS, back pain is correlated with age. In those with relevant back pain at baseline, surgery is associated with a statistically significant and clinically relevant reduction of pain 24 months later, in skeletally mature young adults and adolescents alike.

Level of Evidence

Level III.

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Authors and Affiliations

  1. Spine Center, Schulthess Klinik, Lengghalde 2, 8008, Zurich, Switzerland

    Tamás F. Fekete MD, Anne F. Mannion PhD, Daniel Haschtmann MD, Markus Loibl MD, Frank S. Kleinstück MD & Dezső J. Jeszenszky MD, PhD

Authors
  1. Tamás F. Fekete MD
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  2. Anne F. Mannion PhD
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  3. Daniel Haschtmann MD
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  4. Markus Loibl MD
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  5. Frank S. Kleinstück MD
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  6. Dezső J. Jeszenszky MD, PhD
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Corresponding author

Correspondence to Tamás F. Fekete MD.

Additional information

Author disclosures: TFF (personal fees from DePuy Synthes, outside the submitted work), AFM (none), DH (none), ML (none), FSK (none), DJJ (personal fees from DePuy Synthes, outside the submitted work).

IRB approval: KEK-ZH-Nr. 2014-0418.

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Fekete, T.F., Mannion, A.F., Haschtmann, D. et al. Back Pain and Its Change After Surgery in Adolescents and Young Adults With Idiopathic Scoliosis. Spine Deform 7, 754–758 (2019). https://doi.org/10.1016/j.jspd.2019.02.004

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  • DOI: https://doi.org/10.1016/j.jspd.2019.02.004

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