Does Scoliosis Surgery Hurt?

Written and reviewed for scientific and factual accuracy by Dr. Austin Jelcick, PhD and Dr. Matthew Janzen, DC. Last reviewed/edited on February 27, 2020. First published August 29, 2018.

Many patients with scoliosis who are considering ask the question does scoliosis surgery hurt? What levels of pain are to be expected with spinal fusion surgery and how long can you expect the pain to last during recovery? Despite what many surgeons may immediately tell you, scientific studies have been performed to assess and better understand if spinal fusion surgery causes pain, and if so, how much and for how long.

Pain experienced immediately following scoliosis surgery is described as “severe”  and “a challenge for the anesthesiologist.” (Borgeat and Blumenthal 2008)  The severity of pain is combated with increasing the amounts of drugs used, which may include, intravenous morphine, acetaminophen, ketorolac, methocarbamol, and diazepam.

The more severe the acute pain following surgery, the greater the likelihood that it will give way to chronic, debilitating pain.  Debilitating pain is defined as pain which limits one’s ability to perform daily activities, such as walking to the bathroom or eating a meal.  Recently it was found that one year after surgery, 42% of adolescents experienced debilitating pain.  This compares to only 5% experiencing serious pain prior to surgery.  Children with a chronic pain rating of less than 4 out of 10 were not counted, and the actual incidence of chronic pain post scoliosis surgery may be significantly higher.  (Chidambaran et al. 2017)  This is contrary to the common claim that recovery from scoliosis surgery is complete in 3-6 months.

Frequency of Pain Following Scoliosis Surgery in Children

Predicting Risk for Chronic Pain Following Scoliosis Surgery in Children

Risk factors that were found to be significantly associated with long-term chronic pain:

  • Number of Vertebrae involved: The more vertebra involved in the scoliosis surgery, the higher the rate of chronic and persistent pain.
  • Number of Hours in surgery: For every hour increased in the duration of surgery, there is an increase in the odds of developing chronic persistent pain by 2.16 times
  • Prior Pain: Having pain in the spine prior to surgery is predictive of higher risk for having pain 1 year after the surgery.
  • A High “Child Anxiety Sensitivity Index”: This is a standardized questionnaire that measures the anxiety sensitivity of a child; the higher the score, the greater the risk for chronic pain persisting beyond 1 year.
Scoliosis surgery post-operation pain distribution graph

It is often believed that scoliosis surgery is the only option for treating scoliosis. This is simply not the case. Scoliosis Care Centers offers a variety of comprehensive, individualized nonsurgical treatment options with high rates of success treating mild to severe scoliosis. For more information on the misconceptions about scoliosis please read Are Wrong Beliefs About Scoliosis Hurting our Children.

References

  1. Borgeat, Alain; Blumenthal, Stephan (2008): Postoperative pain management following scoliosis surgery. In Current opinion in anaesthesiology 21 (3), pp. 313–316.
  2. Chidambaran, V.; Ding, L.; Moore, D. L.; Spruance, K.; Cudilo, E. M.; Pilipenko, V. et al. (2017): Predicting the pain continuum after adolescent idiopathic scoliosis surgery. A prospective cohort study. In European journal of pain (London, England) 21 (7), pp. 1252–1265. DOI: 10.1002/ejp.1025.