ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Chronic pain despite anatomical restoration: a prospective cohort study on one-year outcomes and pain predictors following spinopelvic fixation for trauma.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundWhile spinopelvic fixation effectively restores alignment in traumatic injuries, long-term patient-centered outcomes, particularly chronic pain, are poorly characterized. This study aimed to evaluate one-year multidimensional outcomes, with a focused analysis on the prevalence and predictors of chronic pain following this surgery.
methodsA prospective cohort study was conducted at two trauma centers. Forty-five consecutive adult patients with traumatic spinopelvic instability undergoing fixation were enrolled. Outcomes included the Majeed Pelvic Score (MPS), pain (VAS), function (SF-36 PF, Barthel Index), and radiographic alignment. Chronic pain (VAS > 4 for ≥ 2 months beyond 3 months post-op) was a primary focus. Regression analysis was performed to identify predictors of chronic pain. Assessments occurred preoperatively and at 2 weeks, 1, 3, 6, and 12 months.
resultsThe cohort (mean age 41.9 ± 13.5; 73.3% male) showed significant improvement in MPS (from 35.0 ± 8.2 to 84.0 ± 7.1 at one year, p < 0.001) and radiographic parameters (p < 0.001). Despite an overall reduction in mean VAS, chronic pain was prevalent in 77.8% (n = 35). In multivariate logistic regression, independent predictors of chronic pain at one year included higher preoperative VAS (OR = 1.8, 95%CI 1.2-2.7, p = 0.004), the presence of neurological injury at presentation (OR = 4.3, 95%CI 1.1-16.9, p = 0.037), and less optimal postoperative radiographic reduction (vertical displacement >5 mm) (OR = 3.5, 95%CI 1.2-10.1, p = 0.021). The complication rate was 20%.
conclusionSpinopelvic fixation leads to excellent functional and radiographic outcomes. However, chronic pain remains a highly prevalent and distinct challenge. We identified preoperative pain intensity, neurological injury, and suboptimal reduction as key predictors. These findings argue for a stratified postoperative approach, integrating advanced pain management and neurological rehabilitation from the outset for high-risk patients, beyond achieving anatomical success alone. LEVEL OF EVIDENCE: III (Prognostic study).
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