Self-Image Impacts Pain Perception in Scoliosis Patients

Lower deformity perception linked to greater pain reduction in adolescent idiopathic scoliosis

MONDAY, May 9 (HealthDay News) -- The majority of patients with adolescent idiopathic scoliosis (AIS) report experiencing back pain, and those who perceive themselves as less deformed or have less of a desire to change their spinal deformity have a greater reduction in pain after posterior spinal fusion surgery, according to a study published in the May 1 issue of Spine.

Zachary Landman, from the University of California in San Francisco, and colleagues examined the prevalence of back pain due to AIS and its correlation to patients' perceptions of their own appearance before and after surgery. Scoliosis Research Society-22 and Spinal Appearance Questionnaire instruments were administered to 1,433 patients, aged 8 to 22 years, from the Prospective Pediatric Scoliosis Study, before surgery, and to 295 patients one and two years after surgery.

The investigators found that 77.9 percent of patients reported preoperative pain, which was significantly reduced at one and two years after surgery. Increased preoperative pain was significantly correlated with older age, increased body mass index, larger proximal thoracic curve, and a higher score on the Appearance and Appearance Desire scales of the Spinal Appearance Questionnaire. Two years after surgery, patients who perceived themselves as less deformed and had less desire to alter their spinal appearance had greater reductions in pain. The proportion of patients using analgesics was similar before and two years after surgery (28.8 and 29.5 percent, respectively).

"Patients' subjective rating of their trunk appearance and their desire to change it correlated with the amount of preoperative pain and the amount of pain reduction after operation," the authors write.

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