The Potential Role of Preoperative Pain, Catastrophizing, and Differential Gene Expression on Pain Outcomes after Pediatric Spinal Fusion.
The Potential Role of Preoperative Pain, Catastrophizing, and Differential Gene Expression on Pain Outcomes after Pediatric Spinal Fusion.
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DOI：
10.1016/j.pmn.2020.05.007
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Starkweather A
中科院分区：
文献类型：
--
作者：
Perry M;Sieberg CB;Young EE;Baumbauer K;Singh V;Wong C;Starkweather A
青少年特发性脊柱侧凸是儿童和青少年最常见的脊柱畸形之一，需要广泛的手术干预。由于手术的性质，脊柱融合术增加了他们经历持续性术后疼痛的风险。高达20%的青少年报告在矫正脊柱融合手术后数月或数年的疼痛。研究术前心理社会因素和mRNA表达谱对青少年脊柱矫形融合术术后持续疼痛的影响。前瞻性、纵向队列研究。两个独立的学术儿童医院。采用纵向方法，在基线（术前）和术后±1个月和±4-6个月时对青少年进行评价。在每个时间点获得疼痛评分的自我报告、疼痛灾难性量表-儿童和用于RNA测序分析的全血。在入组研究的青少年中，36%在最终术后随访时出现持续性疼痛。持续性疼痛最重要的预测因素包括术前疼痛严重程度和无助感。基因表达分析表明，HLA-DRB 3在术后持续疼痛的儿童中表达增加，而不是那些疼痛消退的儿童。需要一个更大样本量的前瞻性验证研究来证实这些发现。虽然青少年特发性脊柱侧凸通常不被归类为疼痛性疾病，但提供者必须认识到预先存在的疼痛和焦虑可能会导致负面的康复轨迹。政策和做法的改变对于早期识别和随后的干预至关重要。
Adolescent idiopathic scoliosis is one of the most common spinal deformities in children and adolescents requiring extensive surgical intervention. Due to the nature of surgery, spinal fusion increases their risk of experiencing persistent postsurgical pain. Up to 20% of adolescents report pain for months or years after corrective spinal fusion surgery. To examine the influence of preoperative psychosocial factors and mRNA expression profiles on persistent postoperative pain in adolescents undergoing corrective spinal fusion surgery. Prospective, longitudinal cohort study. Two freestanding academic children’s hospitals. Utilizing a longitudinal approach, adolescents were evaluated at baseline (preoperatively) and postoperatively at ±1 month and ±4-6 months. Self-report of pain scores, the Pain Catastrophizing Scale-Child, and whole blood for RNA sequencing analysis were obtained at each time point. Of the adolescents enrolled in the study, 36% experienced persistent pain at final postoperative follow-up. The most significant predictors of persistent pain included preoperative pain severity and helplessness. Gene expression analysis identified HLA-DRB3 as having increased expression in children who experienced persistent pain postoperatively, as opposed to those whose pain resolved. A prospective validation study with a larger sample size is needed to confirm these findings. While adolescent idiopathic scoliosis is not often classified as a painful condition, providers must be cognizant of pre-existing pain and anxiety that may precipitate a negative recovery trajectory. Policy and practice change are essential for early identification and subsequent intervention.
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DOI：
10.3758/s13415-018-0644-y
发表时间：
2019-03
期刊：
Cognitive, affective & behavioral neuroscience
影响因子：
--
作者：
Kokonyei G;Galambos A;Edes AE;Kocsel N;Szabo E;Pap D;Kozak LR;Bagdy G;Juhasz G
通讯作者：
Juhasz G
DOI：
10.1093/bioinformatics/btu638
发表时间：
2015-01-15
期刊：
Bioinformatics (Oxford, England)
影响因子：
--
作者：
Anders S;Pyl PT;Huber W
通讯作者：
Huber W
影响因子：
3
作者：
Asher, M;Lai, SM;Manna, B
通讯作者：
Manna, B
DOI：
10.1111/j.1467-8721.2009.01643.x
发表时间：
2009-08-01
影响因子：
7.2
作者：
Edwards, Robert R.;Campbell, Claudia;Wiech, Katja
通讯作者：
Wiech, Katja
青少年特发性脊柱侧弯和背痛。
影响因子：
--
作者：
Balagué F;Pellisé F
通讯作者：
Pellisé F