title: Predictors of back pain in adolescent idiopathic scoliosis surgical candidates.
abstract: BACKGROUND
  There are contradictory reports on the overall prevalence of back pain in the adolescent population compared with adolescent idiopathic scoliosis (AIS) patients. Most reports do not investigate pain in patients with AIS but try to identify in which subgroup of patients with AIS an underlying pathology should be excluded. The objective of this study was to find whether AIS in operative candidate patients is a painful condition and to try and find clinical and radiologic predisposing factors, which will help us to predict patients who are going to have pain.
  
  
  METHODS
  Candidates who had to undergo an operative treatment for AIS between October 2004 and October 2009 in our institution, were enrolled to the study. Pain was graded with the use of visual analogue scale (VAS) on a scale from 0 to 10. We recorded the age at presentation, sex, menarchal status, family history of scoliosis, brace treatment history, and neurological findings. Radiologic parameters recorded were: the type of curve according to the Lenke classification, Cobb angle, thoracic kyphosis angle, apex vertebra rotation, Risser grade, coronal balance, and curves flexibility.
  
  
  RESULTS
  Seventy patients with AIS were included in this study. Fifty patients (71%) reported of some kind of back pain with 34 patients (48%) grading their pain as ≥5 on the VAS.Patients in whom scoliosis was diagnosed in older age and patients with a more rigid lumbar curve had statistically significant higher VAS scores (P=0.014, P=0.036). Patients who were treated with a brace had a statistically significant lower VAS scores (P=0.019).
  
  
  CONCLUSIONS
  Back pain is common in patients with AIS who are candidates for operative treatment. The following parameters correlate with worse back pain: older age at diagnosis, no use of brace, and rigid lumbar curve.
  
  
  METHODS
  Type III.
authors.affiliation: The Spine Unit, Assaf Harofeh Medical Center, Zerifin, Israel. noam_yossi@yahoo.com
authors.forename: Yossi
authors.initials: Y
authors.lastname: Smorgick
authors.forename: Yigal
authors.initials: Y
authors.lastname: Mirovsky
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Baker
authors.forename: Yael
authors.initials: Y
authors.lastname: Gelfer
authors.forename: Erez
authors.initials: E
authors.lastname: Avisar
authors.forename: Yoram
authors.initials: Y
authors.lastname: Anekstein
mesh_terms: D000293:Adolescent; D001416:Back Pain / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012600:Scoliosis / Q000150:complications* / Q000601:surgery; D055815:Young Adult