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

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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.

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Acknowledgements

The study was financially supported by AOTK (CEF, JAO and MSG) and the Shriners Hospitals (CEF and JAO).

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Authors and Affiliations

  1. McGill Scoliosis and Spine Research Group, Montreal, Canada

    Alisson R. Teles, Maxime St-Georges, Fahad Abduljabbar, Leonardo Simões, Fan Jiang, Neil Saran, Jean A. Ouellet & Catherine E. Ferland

  2. Integrated Program in Neurosciences, McGill University, Montreal, Canada

    Alisson R. Teles & Catherine E. Ferland

  3. Shriners Hospitals for Children-Canada, 1003, boul. Décarie, Montreal, QC, H4A 0A9, Canada

    Alisson R. Teles, Maxime St-Georges, Fahad Abduljabbar, Leonardo Simões, Fan Jiang, Neil Saran, Jean A. Ouellet & Catherine E. Ferland

  4. Department of Experimental Surgery, McGill University, Montreal, Canada

    Maxime St-Georges, Jean A. Ouellet & Catherine E. Ferland

  5. Department of Orthopedic Surgery, King Abdulaziz University, Jeddah, Saudi Arabia

    Fahad Abduljabbar

  6. Spine Service, Hospital Rios D’or, Rio de Janeiro, Brazil

    Leonardo Simões

  7. Division of Orthopedics, Department of Surgery, McGill University, Montreal, Canada

    Fahad Abduljabbar, Fan Jiang, Neil Saran & Jean A. Ouellet

  8. Department of Anesthesia, McGill University, Montreal, Canada

    Catherine E. Ferland

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  1. Alisson R. Teles
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Teles, A.R., St-Georges, M., Abduljabbar, F. et al. Back pain in adolescents with idiopathic scoliosis: the contribution of morphological and psychological factors. Eur Spine J 29, 1959–1971 (2020). https://doi.org/10.1007/s00586-020-06489-2

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