{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T16:25:08Z","timestamp":1771604708228,"version":"3.50.1"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T00:00:00Z","timestamp":1661126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>This retrospective study was designed to explore the types of postoperative pain trajectories and their associated factors after spine surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>This study was conducted in a single medical center, and patients undergoing spine surgery with intravenous patient-controlled analgesia (IVPCA) for postoperative pain control between 2016 and 2018 were included in the analysis. Maximal pain scores were recorded daily in the first postoperative week, and group-based trajectory analysis was used to classify the variations in pain intensity over time and investigate predictors of rebound pain after the end of IVPCA. The relationships between the postoperative pain trajectories and the amount of morphine consumption or length of hospital stay (LOS) after surgery were also evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 3761 pain scores among 547 patients were included in the analyses and two major patterns of postoperative pain trajectories were identified: Group 1 with mild pain trajectory (87.39%) and Group 2 with rebound pain trajectory (12.61%). The identified risk factors of the rebound pain trajectory were age less than 65 years (odds ratio [OR]: 1.89; 95% <jats:italic>CI<\/jats:italic>: 1.12\u20133.20), female sex (<jats:italic>OR<\/jats:italic>: 2.28; 95% <jats:italic>CI<\/jats:italic>: 1.24\u20134.19), and moderate to severe pain noted immediately after surgery (<jats:italic>OR<\/jats:italic>: 3.44; 95% <jats:italic>CI<\/jats:italic>: 1.65\u20137.15). Group 2 also tended to have more morphine consumption (<jats:italic>p<\/jats:italic> &amp;lt; 0.001) and a longer length of hospital stay (<jats:italic>p<\/jats:italic> &amp;lt; 0.001) than Group 1.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The group-based trajectory analysis of postoperative pain provides insight into the patterns of pain resolution and helps to identify unusual courses. More aggressive pain management should be considered in patients with a higher risk for rebound pain after the end of IVPCA for spine surgery.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.907126","type":"journal-article","created":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T05:47:56Z","timestamp":1661147276000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Group-based trajectory analysis of acute pain after spine surgery and risk factors for rebound pain"],"prefix":"10.3389","volume":"9","author":[{"given":"Yi-Shiuan","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuang-Yi","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih-Pin","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming-Chau","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Kuei","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1097\/EJA.0000000000001448","article-title":"Pain management after complex spine surgery: a systematic review and procedure-specific postoperative pain management recommendations.","volume":"38","author":"Waelkens","year":"2021","journal-title":"Eur J Anaesthesiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1097\/ACO.0000000000000494","article-title":"Management of complex spine surgery.","volume":"30","author":"Lamperti","year":"2017","journal-title":"Curr Opin Anaesthesiol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1097\/BRS.0000000000000165","article-title":"Current trends in demographics, practice, and in-hospital outcomes in cervical spine surgery: a national database analysis between 2002 and 2011.","volume":"39","author":"Marquez-Lara","year":"2014","journal-title":"Spine (Phila Pa 1976)."},{"key":"B4","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1097\/ALN.0b013e31828866b3","article-title":"Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures.","volume":"118","author":"Gerbershagen","year":"2013","journal-title":"Anesthesiology."},{"key":"B5","doi-asserted-by":"publisher","first-page":"S99","DOI":"10.1016\/j.spinee.2015.07.046","article-title":"Patients\u2019 experience and expectations of lumbar spine surgery for degenerative conditions: a qualitative study.","volume":"15","author":"Archer","year":"2015","journal-title":"Spine J."},{"key":"B6","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1016\/j.jocn.2015.01.003","article-title":"Best evidence in multimodal pain management in spine surgery and means of assessing postoperative pain and functional outcomes.","volume":"22","author":"Devin","year":"2015","journal-title":"J Clin Neurosci."},{"key":"B7","doi-asserted-by":"publisher","first-page":"729","DOI":"10.1016\/j.spinee.2021.01.001","article-title":"Consensus statement for perioperative care in lumbar spinal fusion: enhanced recovery after surgery (ERAS(R)) society recommendations.","volume":"21","author":"Debono","year":"2021","journal-title":"Spine J."},{"key":"B8","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.spinee.2011.12.003","article-title":"Morbidity and mortality of major adult spinal surgery. 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