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Pilot Investigation of Somatosensory Functioning and Pain Catastrophizing in Pediatric Spinal Fusion Surgery

  • Christine B. Sieberg
    Correspondence
    Address correspondence to Christine B. Sieberg, Biobehavioral Pain Innovations Lab, Boston Children's Hospital, 21 Autumn Street, Boston, MA 02115.
    Affiliations
    Biobehavioral Pain Innovations Lab, Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts

    Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts

    Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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  • Claire E. Lunde
    Affiliations
    Biobehavioral Pain Innovations Lab, Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts

    Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts

    Nuffield Department of Women's and Reproductive Health, Medical Sciences Division, University of Oxford, Oxford, England
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  • Cindy Wong
    Affiliations
    Biobehavioral Pain Innovations Lab, Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts
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  • Juliana Manganella
    Affiliations
    Biobehavioral Pain Innovations Lab, Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts
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  • Angela R. Starkweather
    Affiliations
    Biobehavioral Nursing Science, University of Florida, Gainesville, Florida
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  • Navil Sethna
    Affiliations
    Biobehavioral Pain Innovations Lab, Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts

    Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts

    Mayo Family Pediatric Pain Rehabilitation Center, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts

    Department of Anesthesiology, Harvard Medical School, Boston, Massachusetts
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  • Mallory A. Perry-Eaddy
    Affiliations
    University of Connecticut, School of Nursing, Storrs, Connecticut

    University of Connecticut, School of Medicine, Department of Pediatrics, Storrs, Connecticut

    University of Connecticut, Institute for Collaboration on Health, Intervention, and Policy (InCHIP), Storrs, Connecticut

    Pediatric Intensive Care Unit, Connecticut Children's, Hartford, CT
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Published:December 21, 2022DOI:https://doi.org/10.1016/j.pmn.2022.11.001

      Abstract

      Purpose

      Chronic post-surgical pain (CPSP) is a significant concern and contributes to the opioid epidemic; however, little is known about CPSP in young people.

      Design

      This prospective study aimed to identify sensory, psychological, and demographic factors that may increase the risk of CPSP after spinal fusion surgery for children and adolescents with idiopathic scoliosis.

      Methods

      32 children and adolescents from two children's hospitals completed quantitative sensory testing (QST) and the Pain Catastrophizing Scale Child (PCS-C) pre-and 4-6 months post spinal fusion surgery. Between-group differences were assessed using an independent samples t-test. Pearson's correlations and stepwise linear regression were used to assess the relationship between variables at both time points.

      Results

      56% of patients endorsed pain post-surgery. They were more sensitive tomechanical detection on both a control non-pain site (r = -2.87, p = .004) and the back (r = -1.83, p = .04), as well as pressure pain (r=−2.37, p = .01) on the back. This group also reported worse pain scores pre-surgery. Pre-surgery helplessness positively correlated with preoperative pain (r = .67 p < .001), and age was negatively correlated with the post-surgical catastrophizing total score (r =-.39, p = .05), suggesting that younger patients endorsed more pain-related worry after surgery.

      Conclusions

      Patients who present with pain during their preoperative appointment may need to be monitored with increased vigilance throughout the perioperative period, possibly with bedside QST and psychological questionnaires, which nurses could administer. Biobehavioral interventions targeting pain intensity and feelings of helplessness and anxiety during the preoperative period may alleviate the transition to CPSP.
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