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Patients had less pain relief than expected after lumbar spine surgery

Issue: December 2016

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BOSTON — Although patients who underwent lumbar spine surgery experienced less back pain 2 years postoperatively, the improvement was often less than the amount patients expected, according to results presented at the North American Spine Society Annual Meeting.

“Our study provides evidence that expecting greater pain improvement preop was associated with patients rating a less pain improvement postop,” Federico P. Girardi, MD, said in his presentation here.

Federico P. Girardi

Girardi and colleagues used the Lumbar Spine Surgery Expectations Survey to measure the amount of pain improvement 2 years after lumbar spine surgery among 422 patients (55% men). Patients rated back and leg pain intensity, completed a survey for depressive symptoms and reported any subsequent spine surgery, according to researchers.

Results showed 89% of patients reported at least some improvement regarding pain relief, while 11% reported no improvement. Girardi noted patients who expected greater improvement preoperatively experienced less improvement postoperatively.

“When you combine the amount of pain relief, either a lot or complete, 56% of these patients had less pain improvement then they expected,” Girardi said.

Patients also had less improvement at 2-year follow-up if they had symptoms for a longer period of time, had a positive screen for depression, were having revision surgery, had surgery at L4 or L5, had a degenerative diagnosis, had a subsequent surgery or had less decrease in back and leg pain intensity, according to results. – by Casey Tingle

Reference:

Mancuso CA, et al. Paper #122. Presented at: North American Spine Surgery Annual Meeting; Oct. 26-29, 2016; Boston.

Disclosure: Girardi reports he receives royalties from Lanx, NuVasive, Ortho Development Corp. and DePuy Spine; has stock ownership in Small Bone Innovations, Pioneer Surgical Technology, LifeSpine, Centinel Spine, Spinal Kinetics and Paradigm Spine; is a consultant for Lanx, Gerson Lehrman Group, SpineArt USA, Ortho Development Corp. and DePuy Spine; has speaking or teaching arrangements with PharmaWrite; is on the Scientific Advisory Board for Scient’x USA, Spinal Kinetics, Centinel Spine, SpineArt USA, HealthpointCapital and Paradigm Spine.