Back pain in adolescents with spinal deformities

Abstract

Back pain prevalence ranges from 7 to 58% of subjects aged between 13 and 15, equally distributed in males and females. Back pain is thought to be associated with spinal deformities but no studies investigated the prevalence of back pain in different spinal deformities like, spondylolisthesis, Scheuermann disease, hyperkyphosis, scoliosis. To document the prevalence of back pain, in all its forms in a large population of adolescents with spine deformities and to investigate the association of back pain and different spine pathologies. All the patients visited in 2010–2015 were asked for pain at first clinical evaluation by a single expert physician. PAINGroup and NOPAINGroup were formed. Pain description was then classified into 4 subtypes (localized or generalized, limiting or occasional). Inclusion criteria: age between 10 and 18, spine deformity diagnosis, Exclusion criteria: secondary deformities and other associated pathologies. Descriptive statistics. t -test to check the difference in the two groups considered for SRS-22 score, age and BMI. Chi 2 test to check the association between the presence of pain and diagnosis and pain subtypes; sports activities and previous treatment with brace. In total, 702 patients were included (males n = 468), mean age 13.3 ± 1.92. Subjects’ diagnosis: adolescent idiopathic scoliosis ( n = 387; 55.1%), sagittal unbalance (idiopathic) ( n = 134; 19.1%) Scheuermann deformities ( n = 67; 9.55%); all other diagnosis ( n = 114; 16.2%). In AIS 32% referred pain, 55% in sagittal unbalanced patients and 52% in Scheuermann disease. Only Scheuermann disease predispose to pain (Chi 2 = 10.2, Fisher exact test = 0.002), Sagittal unbalance is slightly associated to pain with Chi 2 = 3.65, Fisher exact test = 0.05. BMI, age, sports and brace were not associated with SRS-22. This is the first study investigating the epidemiology of different type of back pain in a large adolescents population with spinal deformities, Scheuermann deformity resulted associated to pain.