Abstract
Study design: Retrospective prognostic study.
Objectives: To describe the prevalence of pain following fusion for adolescent idiopathic scoliosis
and to identify factors associated with pain and disability.
Methods: From 126 consecutive patients surgically treated for scoliosis between 1997 and 2007,
104 (82.5%) completed SRS-22 and ODI questionnaires at a last follow-up (mean, 4.8
years; range 1–11.2 years). Prevalence of pain and disability were determined from
SRS questions 1 and 9 respectively, with “any” pain or decrease in activity considered
clinically significant. SRS Pain Domain Scores (PDS) were also evaluated.
Results: Most participants reported “no pain” (38.5%) or “mild pain” (30.8%) and 72.1% of
participants reported a current work/school activity level of 100% normal. An association
between instrument type and the presence of any pain in the previous 6 months was
noted (P = .022). Instrument type was the only factor that was significantly associated with
the PDS (P = .0052).
Conclusions: The high percentage of patients reporting no pain or mild pain may suggest overall
success of the procedures. Although an association between instrument type and pain
was seen, unmeasured factors that contributed to the decision of what instrument to
use may confound the relationship. From these data a causal inference cannot be made.
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Final class of evidence-prognosis
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Study design
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Prospective Cohort
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Retrospective Cohort
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Case control
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Case series
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Methods
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Patients at similar point in course of treatment
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F/U ≥ 85%
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Similarity of treatment protocols for patient groups
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Patients followed up long enough for outcomes to occur
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Control for extraneous risk factors
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Overall class of evidence
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III
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The definiton of the different classes of evidence is available on page 55.
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*Potentially confounding factors were systematically explored and considered for stratified
analysis as appropriate.
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