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Topic:

Adolescent Idiopathic Scoliosis

Issue:

Spine

Category:

Developmental

Title:

Does a Preoperative Mental Health Diagnosis Affect Pain Management in Patients With Adolescent Idiopathic Scoliosis Undergoing Surgery?

Author:

Bennett, James T. MD; Chung, Hoon MSc; Artz, Nicolas MSc; Abraham, Vivek M. MD; Andrews, Albert MD; Wells, Douglas Jr MD; Cardelia, Marc MD; St. Remy, Carl MD

Journal:

Journal of Pediatric Orthopaedics

Date:

January 2024

Reference:

44(1): p e35-e39, DOI: 10.1097/BPO.0000000000002545

Level Of Evidence:

III

# of Patients:

417

Study Type:

Retrospective study

Location:

Single center (not specified)

Summary:

This study investigates whether a preoperative mental health disorder (MHD) affects pain management and postoperative outcomes in pediatric patients with adolescent idiopathic scoliosis (AIS) undergoing posterior spinal fusion (PSF).

Methods:

Inclusion Criteria: Pediatric patients with AIS who required PSF and had a minimum of 2 years of follow-up. Exclusion Criteria: Not specified. Intervention: Comparison of pain management outcomes between patients with and without preoperative mental health disorders. Outcomes Measured: Pain score (postoperative) Patient-controlled analgesia (PCA) demand during inpatient stay Narcotic pain medication use at first follow-up Length of hospital stay Data Analysis: Independent Student t-test and χ2 analysis to compare the two groups.

Exclusions:

Not specified

Results:

Pain Scores: MHD group: Mean pain score 3.93 Control group: Mean pain score 3.34 PCA Demand: MHD group: 236.7 units Control group: 140.0 units Length of Stay: MHD group: 4.7 days Control group: 4.6 days Narcotic Pain Medication at First Follow-up: MHD group: 25.8% still using narcotics Control group: 12.0% still using narcotics

Conclusions:

Patients with AIS and a preoperative mental health disorder experience more pain after surgery and require more pain medication during recovery compared to those without a mental health disorder.

Relevance:

Relevance Test

Limitations:

Exclusion of non-English speakers and families without mobile phones

Perspective:

Perspective Test

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