title: Improvement in Scoliosis Research Society-22R Pain Scores After Surgery for Adolescent Idiopathic Scoliosis.
abstract: METHODS
  Longitudinal cohort.
  
  
  OBJECTIVE
  To investigate whether patients with painful adolescent idiopathic scoliosis experience pain relief with surgical treatment.
  
  
  BACKGROUND
  Adolescent idiopathic scoliosis (AIS) was previously thought to be a painless condition, but recent studies have shown that a significant proportion of patients have pain. Little information is available regarding pain relief with surgical treatment for AIS.
  
  
  METHODS
  Patients enrolled in a prospective database of surgically treated AIS were divided into two groups based on their preoperative Scoliosis Research Society (SRS)-22R pain domain score. Patients with a preoperative pain domain score of 4 or more (N = 1005) were classified as nonpainful. If the preoperative pain domain score was less than 4 (N = 505), they were classified as painful. Demographics, SRS total and domain scores, and changes with treatment were compared for the two groups.
  
  
  RESULTS
  The two groups had similar demographics and preoperative coronal curve magnitude. Patients with painful scoliosis experienced significant improvement in SRS-22R pain scores, from 3.29 preoperatively to 4.03 postoperatively (P < 0.000). Eighty-one percent of these patients reached the minimum clinically important difference threshold (0.20) for improvement in pain score. Painful scoliosis patients also had greater 2-year improvement in total and all domain scores than the nonpainful scoliosis patients (P < 0.000). Absolute values of SRS-22R total and domain scores were all greater at 2 years in the nonpainful group than the painful group.
  
  
  CONCLUSIONS
  Patients with AIS with substantial back pain can be cautiously counseled to expect significant improvement in pain level with surgical correction of their deformity, even if curve progression is the primary indication for surgery. Although these patients achieve greater improvements in health-related quality of life compared with patients with mild or no pain, 2-year SRS-22R scores were still better in patients with mild or no pain preoperatively.
  
  
  METHODS
  2.
authors.affiliation: Norton Leatherman Spine Center, Louisville, KY.
authors.forename: Mladen
authors.initials: M
authors.lastname: Djurasovic
authors.affiliation: Norton Leatherman Spine Center, Louisville, KY.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Glassman
authors.affiliation: Texas Scottish Rite Hospital, Dallas, TX.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Sucato
authors.affiliation: The Spine Hospital, Columbia University Medical Center, New York, NY.
authors.forename: Lawrence G
authors.initials: LG
authors.lastname: Lenke
authors.affiliation: Norton Leatherman Spine Center, Louisville, KY.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Crawford
authors.affiliation: Norton Leatherman Spine Center, Louisville, KY.
authors.forename: Leah Y
authors.initials: LY
authors.lastname: Carreon
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology / Q000601:surgery*; D010147:Pain Measurement; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D012600:Scoliosis / Q000150:complications / Q000601:surgery*