Postoperative Evaluation of Pain and Disability in Patients Undergoing Spinal Discectomy

Kumar Abhinav; Dikpal Jadhav; Arun Kumar Agrawal; Rama Agrawal; Ankita Agrawal

doi:10.7759/cureus.49963

Postoperative Evaluation of Pain and Disability in Patients Undergoing Spinal Discectomy

Cureus. 2023 Dec 5;15(12):e49963. doi: 10.7759/cureus.49963. eCollection 2023 Dec.

Authors

Kumar Abhinav¹, Dikpal Jadhav², Arun Kumar Agrawal³, Rama Agrawal⁴, Ankita Agrawal⁵

Affiliations

¹ Department of Neurosurgery, Lilavati Hospital and Research Centre, Mumbai, IND.
² Department of Neurosurgery, King Edward Memorial (KEM) Hospital, Mumbai, IND.
³ Department of Neurosurgery, Patna Medical College and Hospital, Patna, IND.
⁴ Department of Physiology, Patna Medical College and Hospital, Patna, IND.
⁵ Department of Conservative Dentistry and Endodontics, Buddha Institute of Dental Sciences and Hospital, Patna, IND.

Abstract

Background: A spinal discectomy surgery (SDS) is a common surgical procedure performed to treat lumbosacral radiculopathy.

Aim: To evaluate postoperative patterns of pain and disability in patients undergoing spinal discectomy.

Methods and materials: This investigation was a retrospective longitudinal review of prospective information gathered from 543 enrolled patients for lumbar radiculoplasty. The study participants were divided into two categories: Category 1 (SDS) comprising patients of lumbar radiculoplasty managed with SDS (n=270) and Category 2 (non-SDS) comprising patients of lumbar radiculoplasty managed with therapy other than SDS (n=273). It included study participants taking medication for pain control including opioids and non-opioids and physiotherapy for strengthening lower back muscles. At baseline, three months, 12 months, and 24 months after surgery, patient-reported information was gathered. Leg pain magnitude, back pain magnitude, and pain-related impairment were the key outcome metrics of interest.

Results: The mean postoperative visual analog scale (VAS) score for leg pain at three-month follow-up was 4.3±1.2 in study participants in SDS and 8.1±1.3 in the non-SDS category. The VAS score was lower in the SDS category showing greater reduction in postoperative pain with statistically meaningful results (p<0.001). The mean postoperative VAS score at 12-month follow-up was 2.8±1.1 in study participants in SDS and 7.9±1.5 in the non-SDS category. The VAS score was lower in the SDS category showing greater reduction in postoperative pain with statistically meaningful results (p<0.001). The mean postoperative VAS score at 24-month follow-up was 1.7±1.2 in study participants in SDS and 7.1±1.1 in the non-SDS category. The VAS score was lower in the SDS category showing greater reduction in postoperative pain with statistically meaningful results (p<0.001).

Conclusion: It was observed that after discectomy, patients suffering from lumbar radiculopathy have significant pain and disability recovery. According to these results, only a small percentage of individuals exhibit negative results at the level of impairment.

Keywords: disability; neurosurgery; pain; postoperative patterns; spinal discectomy.