Smorgick Yossi, Mirovsky Yigal, Baker Kevin C, Gelfer Yael, Avisar Erez, Anekstein Yoram
The Spine Unit, Assaf Harofeh Medical Center, Zerifin, Israel.
J Pediatr Orthop. 2013 Apr-May;33(3):289-92. doi: 10.1097/BPO.0b013e31827d0b43.
There are contradictory reports on the overall prevalence of back pain in the adolescent population compared with adolescent idiopathic scoliosis (AIS) patients. Most reports do not investigate pain in patients with AIS but try to identify in which subgroup of patients with AIS an underlying pathology should be excluded. The objective of this study was to find whether AIS in operative candidate patients is a painful condition and to try and find clinical and radiologic predisposing factors, which will help us to predict patients who are going to have pain.
Candidates who had to undergo an operative treatment for AIS between October 2004 and October 2009 in our institution, were enrolled to the study. Pain was graded with the use of visual analogue scale (VAS) on a scale from 0 to 10. We recorded the age at presentation, sex, menarchal status, family history of scoliosis, brace treatment history, and neurological findings. Radiologic parameters recorded were: the type of curve according to the Lenke classification, Cobb angle, thoracic kyphosis angle, apex vertebra rotation, Risser grade, coronal balance, and curves flexibility.
Seventy patients with AIS were included in this study. Fifty patients (71%) reported of some kind of back pain with 34 patients (48%) grading their pain as ≥5 on the VAS.Patients in whom scoliosis was diagnosed in older age and patients with a more rigid lumbar curve had statistically significant higher VAS scores (P=0.014, P=0.036). Patients who were treated with a brace had a statistically significant lower VAS scores (P=0.019).
Back pain is common in patients with AIS who are candidates for operative treatment. The following parameters correlate with worse back pain: older age at diagnosis, no use of brace, and rigid lumbar curve.
Type III.
与青少年特发性脊柱侧凸（AIS）患者相比，关于青少年人群背痛总体患病率的报道相互矛盾。大多数报道并未对AIS患者的疼痛情况进行调查，而是试图确定在AIS患者的哪个亚组中应排除潜在病理因素。本研究的目的是确定手术候选患者中的AIS是否为疼痛性疾病，并试图找出临床和放射学的易感因素，以帮助我们预测哪些患者会出现疼痛。
选取2004年10月至2009年10月期间在我院因AIS必须接受手术治疗的患者作为研究对象。使用视觉模拟量表（VAS）将疼痛程度分为0至10级。我们记录了就诊时的年龄、性别、月经初潮状态、脊柱侧凸家族史、支具治疗史和神经学检查结果。记录的放射学参数包括：根据Lenke分类的曲线类型、Cobb角、胸椎后凸角、顶椎旋转度、Risser分级、冠状面平衡和曲线柔韧性。
本研究共纳入70例AIS患者。50例患者（71%）报告有某种程度的背痛，其中34例患者（48%）的疼痛在VAS上评分为≥5分。诊断时年龄较大的患者以及腰椎曲线较僵硬的患者，其VAS评分在统计学上显著更高（P=0.014，P=0.036）。接受支具治疗的患者VAS评分在统计学上显著更低（P=0.019）。
对于手术候选的AIS患者，背痛很常见。以下参数与更严重的背痛相关：诊断时年龄较大、未使用支具以及腰椎曲线僵硬。
III型。
