• Spine · Jul 2019

    Health-Related Quality of Life and Postural Changes of Spinal Alignment in Female Adolescents Associated with Back Pain in Adolescent Idiopathic Scoliosis - A Prospective Cross-Sectional Study.

    • Takahiro Makino, Takashi Kaito, Yusuke Sakai, Shota Takenaka, and Hideki Yoshikawa.
    • Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
    • Spine. 2019 Jul 15; 44 (14): E833-E840.

    Study DesignA prospective cross-sectional study.ObjectiveTo identify risk factors for chronic back pain and back pain at rest in adolescent idiopathic scoliosis (AIS) patients, particularly focusing on the psychological backgrounds of the patients and on postural changes of radiographical parameters for spinal alignment.Summary Of Background DataBack pain has been recognized as a relatively common condition in AIS. However, the effect of patients' psychological backgrounds and dynamic changes of spinal alignment on back pain are unclear.MethodsOne hundred two consecutive female AIS patients (mean age, 14.1 yrs [range, 10-18]) who first visited our outpatient clinic between July 2013 and December 2017 were included. Using SRS-22r questionnaire, the presence of chronic back pain and back pain at rest and the scores of self-image and mental health were evaluated. Using full-length standing and supine posteroanterior radiographs, parameters related to curve profiles and coronal global balance were measured, and postural changes of these parameters were calculated. From full-length standing lateral radiographs, sagittal spinal and spino-pelvic alignment parameters were also measured. Multivariate logistic regression analysis was performed to identify risk factors for back pain.ResultsThe prevalence of chronic back pain was 22.5% and that of back pain at rest was 25.5%. Poor self-image and mental health scores in SRS-22r were identified as risk factors for chronic back pain. Higher Risser grade, poor self-image score, large postural changes of apical vertebral translation at the main thoracic curve, and hyperlordosis in the lumbar spine were identified as risk factors for back pain at rest.ConclusionPsychological distress and large postural changes of spinal alignment played an important role in the occurrence of back pain. Physicians should pay more attention to mental healthcare of AIS patients as well as to radiographical assessments of curve severity for better health-related quality of life.Level Of Evidence4.

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