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. 2024 Jun 3;16(6):e61611.
doi: 10.7759/cureus.61611. eCollection 2024 Jun.

Effect of Residual Pain After Posterior Fusion Surgery for Lumbar Degenerative Disorders on Health-Related Quality of Life: A Two-Year Follow-Up Using Patient-Reported Outcome Measures

Tatsuya Endo  1   2 , Naohiko Kanemura  2 , Toshikazu Ito  3 , Keita Sato  1 , Takuya Miura  1 , Katsuya Onitsuka  4 , Taku Miyazawa  2 , Keisuke Kubota  2 , Masumi Iwabuchi  1 , Osamu Shirado  1
Affiliations

Effect of Residual Pain After Posterior Fusion Surgery for Lumbar Degenerative Disorders on Health-Related Quality of Life: A Two-Year Follow-Up Using Patient-Reported Outcome Measures

Tatsuya Endo et al. Cureus. .

Abstract

Study design: This is a prospective cohort study.

Purpose: The present study aimed to investigate the effects of residual pain after fusion surgery for lumbar degenerative diseases on quality of life (QOL).

Overview of literature: Residual symptoms after spinal surgery often restrict patients' activities of daily living and reduce their QOL. However, few studies have comprehensively addressed physical, psychological, and social factors.

Methods: The study population included a cohort of 208 patients (mean age: 67.9 years) who had undergone posterior interbody fusion for lumbar degenerative disease between 2012 and 2019. We asked the patients to complete the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and Short Form Health Survey (SF-36) preoperatively, as well as at six, 12, and 24 months postoperatively. The presence of residual postoperative pain (RPP) was determined using the low back pain score of the JOABPEQ at six months postoperatively, and patients with an improvement of < 20 points compared to preoperative assessment were classified as RPP+ based on a previous study.

Results: In all patients, there was a notable postoperative improvement in all JOABPEQ and SF-36 domains compared to preoperative scores. The RPP+ group comprised 60 patients (69.6 years), while the RPP- group comprised 148 patients (67.2 years). In the RPP+ group, the lumbar function in the JOABPEQ and general health in the SF-36 showed limited postoperative enhancement. The pace of improvement in the role-emotional, role-physical, social functioning, vitality, and mental health scores was slower in the RPP+ group compared to the RPP- group.

Conclusions: In the current study, we found that the presence of residual pain at six months postoperatively affected QOL improvement up to 24 months after surgery. Lingering postoperative pain substantially impacted functional incapacity, social engagement, and psychological well-being. Notably, the lumbar function in the JOABPEQ and general health in the SF-36 showed distinct progression patterns in the RPP+ group.

Keywords: heath-related quality of life; lumbar degenerative disease; patient-reported outcome; posterior lumbar fusion; residual pain.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Ethics Committee of Fukushima Medical University issued approval 1842. This study was approved by the Ethics Committee of Fukushima Medical University (Approval code: 1842). The approval date is March 31, 2020. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Study design
RPP, residual postoperative pain
Figure 2
Figure 2. Study flow
JOABPEQ, Japanese Orthopaedic Association Back Pain Evaluation Questionnaire; y.o., years old
Figure 3
Figure 3. Comparison of JOABPEQ data between the RPP+ and RPP- groups
Pre-op., pre-operation; mos., months; f/u, follow-up; RPP, residual postoperative pain * Statistically significant difference
Figure 4
Figure 4. Comparison of SF-36 data between the RPP+ and RPP- groups
Pre-op., preoperation; mos., months; f/u, follow-up; RPP, residual postoperative pain * Statistically significant difference
See this image and copyright information in PMC

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