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Background <p>Pain is common in adolescents with idiopathic scoliosis (AIS), yet its distribution is heterogeneous and mechanisms remain incompletely understood. Beyond structural factors, emerging evidence suggests a psychosocial component with links to mental health. This study examined the relationship between preoperative pain and its distribution with mental health in Lenke type 1–2 AIS patients undergoing posterior spinal fusion.</p> Methods <p>In this prospective single-center cohort study (July 2023–July 2025), Lenke type 1–2 AIS patients completed the revised SRS-22 (SRS-22r) questionnaire and a standardized 10-region pain diagram prior to corrective surgery. Concurrently, coronal and sagittal parameters were measured on EOS imaging. Group comparisons of SRS-22r domain scores between patients with and without pain were performed using the Mann–Whitney U test. An a priori power analysis (80% power, medium effect size 0.3, <i>α</i> = 0.05) indicated that a minimum of 10 patients per parameter was required to detect the intended effect. Univariable linear regressions were conducted to examine the associations between SRS-22r mental health scores, pain regions, and radiographic variables; models were run both unadjusted and adjusted for age, sex, and primary Cobb angle (α &lt; .05).</p> Results <p>Sixty patients (47 female; mean age 16.1 ± 2.3&#xa0;years) were included and divided into a pain group (<i>N</i> = 42) and a no-pain group (<i>N</i> = 18). Patients without preoperative pain demonstrated significantly higher SRS-22r scores across all domains, with the most pronounced difference in mental health (<i>p</i> &lt; 0.001). Within the pain group, neck region pain (R1) was reported by 21.4% of patients and was independently associated with lower mental health scores (<i>β</i> = –0.54, <i>p</i> = .029). No other pain regions or radiographic parameters were significantly associated with mental health outcomes.</p> Conclusion <p>In this study cohort, preoperative axial neck pain was associated with poorer mental health scores, whereas patients without pain consistently reported higher SRS-22r outcomes across all domains. No associations were found with radiographic parameters, underscoring the role of psychosocial factors in AIS and the need for further multicenter studies.</p>

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Preoperative pain experience and distribution in relation to mental health in Lenke type 1 and 2 adolescent idiopathic scoliosis: a prospective cross-sectional study

  • 期刊论文

  • 发表日期：

    2026年3月18日

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  • Paolo Brigato,
  • Ekin Celtikcioglu,
  • Christopher Coluni,
  • Kai Sheng,
  • Ojasvi Sharma,
  • David Tejera,
  • Neil Saran,
  • Lisbet Haglund,
  • Jean Albert Ouellet

摘要

Background

Pain is common in adolescents with idiopathic scoliosis (AIS), yet its distribution is heterogeneous and mechanisms remain incompletely understood. Beyond structural factors, emerging evidence suggests a psychosocial component with links to mental health. This study examined the relationship between preoperative pain and its distribution with mental health in Lenke type 1–2 AIS patients undergoing posterior spinal fusion.

Methods

In this prospective single-center cohort study (July 2023–July 2025), Lenke type 1–2 AIS patients completed the revised SRS-22 (SRS-22r) questionnaire and a standardized 10-region pain diagram prior to corrective surgery. Concurrently, coronal and sagittal parameters were measured on EOS imaging. Group comparisons of SRS-22r domain scores between patients with and without pain were performed using the Mann–Whitney U test. An a priori power analysis (80% power, medium effect size 0.3, α = 0.05) indicated that a minimum of 10 patients per parameter was required to detect the intended effect. Univariable linear regressions were conducted to examine the associations between SRS-22r mental health scores, pain regions, and radiographic variables; models were run both unadjusted and adjusted for age, sex, and primary Cobb angle (α < .05).

Results

Sixty patients (47 female; mean age 16.1 ± 2.3 years) were included and divided into a pain group (N = 42) and a no-pain group (N = 18). Patients without preoperative pain demonstrated significantly higher SRS-22r scores across all domains, with the most pronounced difference in mental health (p < 0.001). Within the pain group, neck region pain (R1) was reported by 21.4% of patients and was independently associated with lower mental health scores (β = –0.54, p = .029). No other pain regions or radiographic parameters were significantly associated with mental health outcomes.

Conclusion

In this study cohort, preoperative axial neck pain was associated with poorer mental health scores, whereas patients without pain consistently reported higher SRS-22r outcomes across all domains. No associations were found with radiographic parameters, underscoring the role of psychosocial factors in AIS and the need for further multicenter studies.