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.

中文翻译：

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青少年特发性脊柱侧弯的背痛：形态和心理因素的贡献。

目的

确定青少年特发性脊柱侧凸 (AIS) 患者的 3D 放射学特征、心理因素与背痛患病率和强度之间的关系。

方法

连续的 AIS 患者回答了自我报告的问卷，并同时接受了脊柱的前后和侧面扫描（EOS Imaging，巴黎，法国）。脊柱和骨盆的 3D 重建报告了冠状面、矢状面和轴向平面的 18 个参数。

结果

研究中包括了 124 名 AIS 患者。总体而言，90% 的 AIS 患者报告在过去 6 个月内有一些背痛，在过去 30 天内有 85.8%。据报道，最近一个月的疼​​痛强度为轻度，37.5%，中度为 31.8%，中度至重度为 24.3%，重度为 6.54%。背痛的位置与主弯的位置相关（P  = 0.036）。腰痛与较高的腰尖 AVR 和较低的腰椎前凸有关（P  < 0.05）。AIS 背痛的独立危险因素是疼痛灾难性 ( B  = 0.061, P  = 0.035)、自我报告的心理健康状况较差 ( B  = − 0.872, P = 0.023），减少胸椎后凸（B  = - 0.033，P  = 0.044）和更大的骨盆不对称（B  = 0.146，P  = 0.047）。过去 24 小时内自我报告的疼痛强度与灾难化水平之间存在显着关联。疼痛灾难化水平影响畸形严重程度与疼痛强度之间的关系。在低灾难者中，更大的畸形严重程度和更高的疼痛程度之间存在显着关联。

结论

AIS 中的背痛是多因素的，并与心理和形态参数有关。疼痛灾难化是 AIS 相关疼痛的重要组成部分，在评估这些患者时应予以考虑。