Predictors of Post-Op Pain ID’d in Adolescent Idiopathic Scoliosis

(HealthDay News) — Higher preoperative levels of pain and anxiety may be risk factors for chronic postsurgical pain for patients with adolescent idiopathic scoliosis (AIS) undergoing posterior spinal fusion, according to a study published in the February 1 issue of Spine.

Mark Connelly, PhD, from the University of Missouri-Kansas City School of Medicine, and colleagues assessed pain outcomes at two weeks, six weeks, three months, and six months postsurgery in 50 patients, aged 11–17 years, with AIS and undergoing posterior spinal fusion surgery. Preoperative predictor variables were assessed two weeks before surgery and perioperative predictor variables were evaluated by self-report and record review.

The researchers found that, on average, the pain level declined predictably with days since surgery (P<0.01), but pain was at or above baseline levels through six months after surgery for 22% of adolescents. Slower improvement in pain was predicted by greater baseline pain and anxiety, while more rapid declines in pain were predicted by greater confidence in ability to control pain. Postsurgical pain trajectories were not modified by demographic or medical variables.

“Although pain typically declines predictably with healing time from spinal fusion surgery for AIS, higher preoperative levels of pain and anxiety may be risk factors for chronic postsurgical pain whereas greater pain coping efficacy may help optimize postsurgical pain outcomes,” the authors write.

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