Pain during the first year after scoliosis surgery in adolescents, an exploratory, prospective cohort study

Thomas G. de Leeuw*, Anneke A. Boerlage, Hanneke M. van West, Jeroen J.M. Renkens, Joost van Rosmalen, Lonneke M.E. Staals, Frank Weber, Dick Tibboel, Saskia N. de Wildt

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Objective: 

Approximately 50% of adolescents who have undergone scoliosis surgery still experience severe pain one year postoperatively. We explored the postoperative pain trajectory and the potential value of preoperative Thermal Quantitative Sensory Testing (T-QST) as predictor of chronic postsurgical pain after scoliosis surgery. 

Design: 

Single-center prospective cohort study in adolescents undergoing scoliosis surgery. 

Outcomes: 

Prevalence of chronic postsurgical pain (CPSP) one year after scoliosis surgery and postsurgical pain course during this year. The need for rescue medication and the relationship between pre-operative T-QST, acute pain and CPSP. 

Results: 

Thirty-nine patients (mean age 13.9 years; SD 1.9 years) completed the study. One year postoperatively, ten patients (26%) self-reported pain [numeric rating scale (NRS) score ≥ 4]) when moving and two (5%) when in rest. Four of these patients (10.3%) experienced neuropathic pain. The pre-operative cold pain threshold was lower (p = 0.002) in patients with CPSP at 12 months. Preoperative cold and heat pain thresholds were correlated with the number of moderate or severe pain reports (NRS ≥ 4) in the first week postoperatively (r -.426; p = 0.009 and r.392; p = 0.016, respectively). 

Conclusions: 

One year after scoliosis surgery, a significant part of patients (26%) still reported pain, some with neuropathic characteristics. Better diagnosis and treatment is needed; our study suggests that T-QST could be further explored to better understand and treat children with this negative outcome.

Original languageEnglish
Article number1293588
JournalFrontiers in Pediatrics
Volume12
DOIs
Publication statusPublished - 8 Mar 2024

Bibliographical note

Publisher Copyright:
2024 de Leeuw, Boerlage, van West, Renkens, van Rosmalen, Staals, Weber, Tibboel and de Wildt.

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