Department of Orthopædic Surgery, University of California, San Francisco, 94143, USA.
Spine (Phila Pa 1976). 2011 May 1;36(10):825-9. doi: 10.1097/BRS.0b013e3181de8c2b.
Multicenter, prospective, consecutive clinical series.
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.
Back pain in idiopathic scoliosis has been noted to be reduced after 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.
We reviewed 1433 patients entered consecutively into the Prospective Pediatric Scoliosis Study, a database of children (8-22 years) undergoing operation for idiopathic scoliosis who have been followed for 1 and 2 years (n = 295) with the Scoliosis Research Society-22 and Spinal Appearance Questionnaire instruments.
Preoperative pain was reported by 77.9% of patients and 44% of surgeons. More preoperative pain correlated with older age (ρ = -.140, P = 0.000), greater body mass index (ρ = -0.168, P = 0.000), larger proximal thoracic curve ρ = -0.086, P = 0.019), and a higher score on the Spinal Appearance Questionnaire Appearance (greater perception of spinal deformity, ρ = -0.223, P = 0.000) and Appearance Desire scales (stronger desire to change the appearance of their spine, ρ = -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 (ρ = -0.284, P < 0.01) or had less desire to change their spinal appearance (ρ = -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).
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.
多中心、前瞻性、连续临床系列。
报告特发性脊柱侧凸后路脊柱融合前后前瞻性队列研究中儿童的背痛及其与患者对外观认知的相关性。
特发性脊柱侧凸患者术后背痛减轻。然而，手术前后背痛的患病率仍存在不确定性。关于患者对外观的认知与术前和术后疼痛之间的相关性数据很少。
我们回顾了连续纳入前瞻性小儿脊柱侧凸研究的 1433 例患者，这是一个数据库，包含接受特发性脊柱侧凸手术的儿童（8-22 岁），随访 1 年和 2 年（n=295），使用 Scoliosis Research Society-22 和脊柱外观问卷量表。
77.9%的患者和 44%的外科医生报告术前疼痛。更多的术前疼痛与年龄较大（ρ=-0.140，P=0.000）、体重指数较大（ρ=-0.168，P=0.000）、较大的近端胸弯（ρ=-0.086，P=0.019）和脊柱外观问卷外观评分较高（对脊柱畸形的感知程度较高，ρ=-0.223，P=0.000）和外观愿望量表（更强烈地改变脊柱外观的愿望，ρ=-0.153，P=0.000）相关。术后 1 年和 2 年疼痛减轻（P=0.0002）。那些认为自己畸形程度较小的患者（ρ=-0.284，P<0.01）或改变脊柱外观愿望较小的患者（ρ=-0.183，P<0.01），术后 2 年疼痛减轻程度更大。术前背痛使用镇痛药的比例较高（28.8%），术后 2 年仍较高（29.5%）（P>0.05）。
背痛影响 75%的特发性脊柱侧凸青少年，后路融合后疼痛减轻。超重、年龄较大和近端胸弯较大的患者报告更多的术前疼痛。那些认为自己畸形程度较高的患者往往有更多的绝对疼痛，术后疼痛减轻程度较小。
