Journal article
Pain After Anterior Vertebral Body Tethering
Spine (Philadelphia, Pa. 1976), v 48(20), pp 1464-1471
15 Oct 2023
PMID: 37470388
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Study Design: Retrospective case series.Objective: To examine the incidence and risk factors for postoperative pain following anterior vertebral body tethering (AVBT) for adolescent idiopathic scoliosis (AIS).Summary of Background Data: Up to 78% of patients with AIS report preoperative pain; it is the greatest patient concern surrounding surgery. Pain significantly decreases following posterior spinal fusion, but pain following AVBT is poorly understood.Materials and Methods: We retrospectively reviewed 279 patients with a two-year follow-up after AVBT for AIS. We collected demographic, radiographic, and clinical data pertinent to postoperative pain at each time interval of preoperative and postoperative visits (6 wk, 6 mo, 1 y, and annually thereafter).Results: Within our cohort, 68.1% of patients reported preoperative pain. Older age (P=0.014) and greater proximal thoracic (P=0.013) and main thoracic (P=0.002) coronal curve magnitudes were associated with preoperative pain. Pain at any time point > 6 weeks postoperatively was reported in 41.6% of patients; it was associated with the female sex (P=0.032), need for revision surgery (P=0.019), and greater lateral displacement of the apical lumbar vertebrae (P=0.028). The association between preoperative and postoperative pain trended toward significance (P=0.07). At 6 months postoperatively, 91.8% had pain resolution; the same number remained pain-free at the time of last follow-up. The presence of a postoperative complication was associated with new-onset postoperative pain that resolved (P=0.009). Only 8.2% had persistent pain, although no risk factors were found to be associated with persistent pain.Conclusion: In our cohort of 279 patients with a minimum 2-year follow-up after AVBT, 68.1% reported preoperative pain. Nearly 42% reported postoperative pain at any time point, but only 8.2% had persistent pain. Postoperative pain after AVBT was associated with female sex, revision surgery, and Lenke lumbar modifier. AVBT is associated with a significant reduction in pain, and few patients report long-term postoperative pain.
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Details
- Title
- Pain After Anterior Vertebral Body Tethering
- Creators
- Michael J. Yang - Tufts Medical CenterAmer F. Samdani - Shriners Hospitals for ChildrenJoshua M. Pahys - Shriners Hospitals for ChildrenAlejandro Quinonez - Shriners Hospitals for ChildrenMaureen McGarry - Shriners Hospitals for ChildrenBrandon Toll - Shriners Hospitals for ChildrenHarsh Grewal - Shriners Hospitals for ChildrenSteven W. Hwang - Shriners Hospitals for Children
- Publication Details
- Spine (Philadelphia, Pa. 1976), v 48(20), pp 1464-1471
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 8
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics; Surgery
- Web of Science ID
- WOS:001094634200010
- Scopus ID
- 2-s2.0-85174055649
- Other Identifier
- 991021930837504721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Clinical Neurology
- Orthopedics