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. 2020 Aug;29(8):1959-1971.
doi: 10.1007/s00586-020-06489-2. Epub 2020 Jun 9.

Back pain in adolescents with idiopathic scoliosis: the contribution of morphological and psychological factors

Alisson R Teles  1   2   3 , Maxime St-Georges  1   3   4 , Fahad Abduljabbar  1   3   5   6 , Leonardo Simões  1   3   7 , Fan Jiang  1   3   6 , Neil Saran  1   3   6 , Jean A Ouellet  1   3   4   6 , Catherine E Ferland  8   9   10   11   12
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Back pain in adolescents with idiopathic scoliosis: the contribution of morphological and psychological factors

Alisson R Teles et al. Eur Spine J. 2020 Aug.

Abstract

Purpose: To define the relationship between 3D radiological features, psychological factors, and back pain prevalence and intensity in patients with adolescent idiopathic scoliosis (AIS).

Methods: Consecutive AIS patients answered self-reported questionnaires and underwent simultaneous posterior-anterior and lateral scans of the spine (EOS Imaging, Paris, France). 3D reconstructions of the spine and pelvis reported 18 parameters in the coronal, sagittal, and axial plane.

Results: Hundred and twenty-four patients with AIS were included in the study. Overall, 90% of AIS patients reported having some back pain over the last 6 months and 85.8% over the last 30 days. Pain intensity in the last month was reported to be mild in 37.5%, moderate in 31.8%, moderate to severe in 24.3%, and severe in 6.54% of cases. Location of back pain was associated with location of main curve (P = 0.036). Low back pain was associated with higher lumbar apical AVR and lower lumbar lordosis (P < 0.05). Independent risk factors for back pain in AIS were pain catastrophizing (B = 0.061, P = 0.035), poorer self-reported state of mental health (B = - 0.872, P = 0.023), decreased thoracic kyphosis (B = - 0.033, P = 0.044) and greater pelvic asymmetry (B = 0.146, P = 0.047). There was a significant association between self-reported pain intensity in the last 24 h and levels of catastrophizing. Pain catastrophizing level influenced the relationship between deformity severity and pain intensity. In low catastrophizers, there was a significant association between greater deformity severity and higher pain levels.

Conclusions: Back pain in AIS is multifactorial and associated with psychological and morphological parameters. Pain catastrophizing is an important construct in AIS-related pain and should be taken into consideration when evaluating these patients.

Keywords: Adolescents; Anxiety; Back pain; Pain; Pain catastrophizing; Scoliosis; Spine.

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References

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