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Updated: Jan 18, 2026
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
Psychological Predictors of Pain Outcomes in Children With Cerebral Palsy Undergoing Orthopaedic Surgery
Elizabeth R Boyer1,2, Allison G Corlett3, Kyle Nickodem4
1Department of Research, Gillette Children's, Saint Paul.
Background:
Many children with cerebral palsy (CP) undergo orthopaedic surgery. Prospective studies exploring patient or psychological factors predictive of pain recovery or chronicity have not been investigated in CP and orthopaedic surgery. In studies with other pediatric clinical samples, preoperative pain, anxiety, and catastrophizing were shown to be predictive of pain outcomes. The purpose of this exploratory study was to (a) quantify pain presence longitudinally before and after orthopaedic surgery in children with CP and (b) identify preoperative factors associated with postoperative pain intensity and interference.
Methods:
Parents of 36 children (mean age=12 y, range=4 to 17) completed online surveys at 1 week preoperative, and 1, 3, 6, and 12 months after spinal fusion (n=10), multilevel lower extremity surgery (n=20), or other orthopaedic surgery (n=6). Pain interference (Brief Pain Inventory-Pain Interference), pain intensity (Numerical Rating Scale 0 to 10), and chronic postsurgical pain (CPSP; new or worsening pain) were the outcome variables. Multilevel modeling was used to identify whether participant demographics (eg, age, sex, gross motor ability) and psychological factors (parent pain catastrophizing and grit) were associated with pain interference and intensity outcomes.
Results:
There was significant variability in pain experience between participants. Moderate to severe pain affected about one-third of participants at all time points, with about one-quarter of participants meeting the criteria for CPSP. Higher parent pain catastrophizing and lower grit were associated with greater pain intensity and interference. Participant age, sex, gross motor ability, and number of prior surgeries were not related to pain outcomes.
Conclusions:
Pain, including moderate to severe pain, was experienced by a substantial proportion of children with CP in this sample both before and after orthopaedic surgery. There is initial evidence that psychological factors may be viable predictors of postsurgical pain outcomes, highlighting opportunities for screening and intervention, though further research is needed.
Level Of Evidence:
Level II.
