Abstract
ObjectivesThe aims of this study are to answer the following questions (1) How does the pain intensity of lumbar and cervical disc surgery patients change within a postoperative time frame of 5 years? (2) Which sociodemographic, medical, work-related, and psychological factors are associated with postoperative pain in lumbar and cervical disc surgery patients?MethodsThe baseline survey (T0; n = 534) was conducted 3.6 days (SD 2.48) post-surgery in the form of face-to-face interviews. The follow-up interviews were conducted 3 months (T1; n = 486 patients), 9 months (T2; n = 457), 15 months (T3; n = 438), and 5 years (T4; n = 404) post-surgery. Pain intensity was measured on a numeric rating-scale (NRS 0–100). Estimated changes to and influences on postoperative pain by random effects were accounted by regression models.ResultsAverage pain decreased continuously over time in patients with lumbar herniated disc (Wald Chi² = 25.97, p<0.001). In patients with cervical herniated disc a reduction of pain was observed, albeit not significant (Chi² = 7.02, p = 0.135). Two predictors were associated with postoperative pain in lumbar and cervical disc surgery patients: the subjective prognosis of gainful employment (p<0.001) and depression (p<0.001).ConclusionIn the majority of disc surgery patients, a long-term reduction of pain was observed. Cervical surgery patients seemed to benefit less from surgery than the lumbar surgery patients. A negative subjective prognosis of gainful employment and stronger depressive symptoms were associated with postoperative pain. The findings may promote multimodal rehabilitation concepts including psychological and work-related support.
Highlights
Degenerative disc disease is commonly accounted as causal in acute and chronic back/leg pain in the general population [1,2,3]
The aims of this study are to answer the following questions (1) How does the pain intensity of lumbar and cervical disc surgery patients change within a postoperative time frame of 5 years? (2) Which sociodemographic, medical, work-related, and psychological factors are associated with postoperative pain in lumbar and cervical disc surgery patients?
Two predictors were associated with postoperative pain in lumbar and cervical disc surgery patients: the subjective prognosis of gainful employment (p
Summary
Degenerative disc disease is commonly accounted as causal in acute and chronic back/leg pain in the general population [1,2,3]. The main function of surgical treatment is the elimination of pain and associated physical dysfunction [6]. Studies showed that surgery helps the majority of patients to overcome pain symptoms [7,8,9], but between 7 and 23% of the operated patients still report severe pain or even experience no pain relief at all [10,11,12,13,14]. While surgical complications may be responsible for persisting symptoms in some patients, these problems do not give an all-embracing explanation for ongoing pain [10,15,16]. Medical, occupational and psychological factors that were associated with persistent pain. Depression [10,11,12,13,17,19,23,24,25,26,27], anxiety [20,27,28] as well as dysfunctional cognitive behavioural factors [12,18,27,28] seem to play a particular role in the maintenance of pain
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