• Mladen Djurasovic, Steven D Glassman, Daniel J Sucato, Lawrence G Lenke, Charles H Crawford, and Leah Y Carreon.
• *Norton Leatherman Spine Center, 210 East Gray Street, Suite #900, Louisville, KY 40202 †Texas Scottish Rite Hospital, 2222 Welborn Street, Dallas, TX 75219 ‡The Spine Hospital, Columbia University Medical Center, 5141 Broadway, 3 Field West, New York, NY 10034.
• Spine. 2016 Nov 15.

Study DesignLongitudinal cohort.ObjectiveTo investigate whether patients with painful adolescent idiopathic scoliosis experience pain relief with surgical treatment.Summary Of Background DataAdolescent 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.MethodsPatients enrolled in a prospective database of surgically treated AIS were divided into two groups based on their preoperative SRS22R pain domain score. Patients with a preoperative pain domain score of ≥ 4 (N = 1005) were classified as non-painful. If the preoperative pain domain score was < 4 (N = 505), they were classified as painful. Demographics, SRS total and domain scores, as well as changes with treatment were compared for the two groups.ResultsThe two groups had similar demographics and pre-op coronal curve magnitude. Patients with painful scoliosis experienced significant improvement in SRS22R pain scores, from 3.29 preoperatively to 4.03 postoperatively (p < 0.000). 81% of these patients reached the MCID threshold (0.20) for improvement in pain score. Painful scoliosis patients also had greater two-year improvement in Total and all domain scores than the non-painful scoliosis patients (p < 0.000). Absolute values of SRS22R Total and domain scores were all greater at two-years in the non-painful group than the painful group.ConclusionsAIS patients 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 to patients with mild or no pain, two-year SRS22R scores were still better in patients with mild or no pain preoperatively.Level Of Evidence2.

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