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Thread: Well we've now gone from AIS does not cause pain to ~75% of AIS kids have back pain

  1. #1
    Join Date
    Jan 2008
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    NC
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    Well we've now gone from AIS does not cause pain to ~75% of AIS kids have back pain

    Medical research... so enlightening.

    PREVALENCE and PREDICTORS of PAIN in SURGICAL TREATMENT of ADOLESCENT IDIOPATHIC SCOLIOSIS

    Zachary, Landman; Mohammad, Diab; members of the Spinal Deformity Study Group

    Spine., POST ACCEPTANCE, 29 December 2010

    Study design: Multicenter, prospective, consecutive clinical series.

    Objective: To report on back pain and its association with patients' perceptions of appearance in a prospective cohort study of children before and after posterior spinal fusion for idiopathic scoliosis.

    Summary of background data: Back pain in idiopathic scoliosis has been noted to be reduced following surgery. However, uncertainty over its prevalence before and after operation persists. There is a paucity of data on correlations between patients' perceptions of their appearance and preoperative and postoperative pain.

    Methods: We reviewed 1433 patients entered consecutively into the Prospective Paediatric Scoliosis Study (PPSS), a database of children (8-22 yr) undergoing operation for idiopathic scoliosis who have been followed for one and two years (n = 295) with the SRS-22 and SAQ instruments.

    Results: Preoperative pain was reported by 77.9% of patients and 44% of surgeons. More preoperative pain correlated with older age (rho = -.140, p = 0.000), greater BMI (rho = -0.168, p = 0.000), larger proximal thoracic curve (rho = -0.086, p = 0.019), and a higher score on the SAQ Appearance (greater perception of spinal deformity, rho = -0.223, p = 0.000) and Appearance Desire scales (stronger desire to change the appearance of their spine, rho = -0.153, p = 0.000).

    Pain was reduced at 1 and 2 years after operation (p = 0.0002). Patients who perceived themselves as less deformed (rho = -0.284, p < 0.01) or had less desire to change their spinal appearance (rho = -0.183, p < 0.01) experienced a greater reduction in pain 2 years after operation.

    Preoperative analgesic use for back pain was high (28.8%) and remained high at 2 years after operation (29.5%) (p > 0.05).

    Conclusions: Back pain affects three-quarters of adolescents with idiopathic scoliosis and is reduced after posterior fusion. Patients who are overweight, older, and have larger proximal thoracic curve magnitudes report more preoperative pain. Patients who view themselves as more deformed tend to have more absolute pain, and less reduction in pain after operation.

    Significance: Pain in AIS is high and our results point to an opportunity for better management in the subgroup who are dissatisfied with their appearance.

    (C) 2011 Lippincott Williams & Wilkins, Inc.
    Sharon, mother of identical twin girls with scoliosis

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  2. #2
    Join Date
    Mar 2009
    Posts
    1,090
    I think the difference is due to these being surgical AIS patients. If I remember correctly, only roughly one percent of kids with AIS progress to surgery. This seems to say that as you progress to surgical level, the pain is found in a much greater percentage of those surgical patients....which would certainly make sense.

  3. #3
    Join Date
    Nov 2010
    Location
    British Columbia
    Posts
    918
    When Elias was first diagnosed at 47* he didn't have any pain at all. I can't recall exactly when he started to complain about back pain but it was when his curve was further along. He definitely complained about a lot of back pain and muscle tightness when his curve was in the 80's* and at 110* he was pretty much in constant pain.
    Son 14 y/o diagnosed January 20th. 2011 with 110* Curve
    Halo Traction & 1st. surgery on March 22nd. 2011
    Spinal Fusion on April 19th. 2011

    Dr. Krajbich @ Shriners Childrens Hospital, Portland Oregon



    http://tinyurl.com/Elias-Before
    http://tinyurl.com/Elias-After

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