Purpose:  Spinal fusion surgery to correct scoliosis in adolescents is an invasive operation followed by a long recovery. The physical challenges and complications adolescents face during recovery are not well understood. This study describes complications that occurred during a 9-month follow-up period and determines their association with coping strategies used.

Method:  113 adolescents (mean age 13.9; 81% female; 84% Caucasian) were recruited prior to surgery. To assess avoidant-vigilant coping, following hospital discharge participants completed the Postoperative Coping Interview at 1, 3, and 6 months.  Complications were assessed by chart reviews.

Findings:  Analysis revealed that 8.05% of patients had major complications during the nine months following surgery, including having to undergo a second surgery for instrumentation problems or intractable infection.  Fifty-eight percent had a minor complication, for example, pain, general discomfort, or numbness in the upper and/or lower extremities.  The incidence of pain was 12% at 1 month, 4% at 3 months and 22% at 9 months.  Coping was significantly associated with minor complications only at one time period:  Vigilant copers at 3 months were less likely to have a minor or major complication at 3 months. However, the adolescents' use of vigilant coping did not remain stable over time.

Discussion:  These findings suggest that long term recovery from spinal surgery does not have a smooth trajectory.  The finding that more participants complained of pain at nine months than at any other time period indicates that their lives still had not returned to normal and their pain needs were not being adequately met. Coping played a role only at 3 months:  More vigilant copers had significantly fewer complications. Understanding the physical challenges adolescents face during recovery can help practitioners be more assiduous in assessment of complications during follow-up clinic visits and call attention to unmet pain needs that should be addressed.