BACK PAIN IN POSTOPERATIVE IDIOPATHIC SCOLIOSIS - LONG-TERM FOLLOW-UP-STUDY

Three hundred twenty patients who had idiopathic scoliosis were treated surgically at the University of Rochester between 1946 and 1972, and all those operated on by the senior author (LAG) were mailed questionnaires concerning the occurrence of low-back pain postoperatively. Of 154 patients who responded to questionnaires, 105 were able to come in for clinical examination and roentgenograms. The distal end of the fusion ranged from LI to L5. The average follow-up time was 13.1 years. The patients were evaluated on multiple parameters. The occurrence of pain was related to level of fusion, length of follow-up, pseudarthrosis, L5 obliquity, hamstring tightness, and degenerative changes. Pain was not related to the type of curve pattern, severity of the curve, loss of correction, lengthening, balance, or treatment with and without Harrington instrumentation. A hyperextension stress (humpsag) test was an elfective clinical test of lumbar and lumbosacral joint pain. The overall incidence of low- back pain was equal to that of a general, nonoperative population study. However, the data indicate a high incidence of low-back symptoms in patients who had only one or two segments open distal to the fusion. An incidental finding was mild interscapular pain in 41 patients and painful iliac graft sites in 6 patients, 10 years after surgery. © 1979 Harper and Row, Publishers, Inc.