Pain Interference Influence on Postoperative Clinical Trajectory in Patients Undergoing Lumbar Decompression

Area of Science:

• Orthopedics
• Pain Management
• Health Outcomes Research

Background:

• Patient-Reported Outcomes (PROs) offer advantages over traditional measures.
• Preoperative pain interference (PI) is a key factor in surgical outcomes.
• The PROMIS Pain Interference (PROMIS-PI) is a newer, validated PRO instrument.

Purpose of the Study:

• To investigate the impact of preoperative PI, measured by PROMIS-PI, on postoperative outcomes in lumbar decompression surgery.
• To compare clinical outcomes between patients with lesser and greater preoperative PI.

Main Methods:

• A retrospective study of 107 patients undergoing lumbar decompression without fusion.
• Patients were stratified into two cohorts based on preoperative PROMIS-PI scores (<64 and ≥64).
• Various PROs were collected pre- and postoperatively, with statistical comparisons between groups.

Main Results:

• All patients showed significant postoperative improvement in most PROs, regardless of preoperative PI.
• The greater PI cohort demonstrated higher Minimum Clinically Important Difference (MCID) achievement rates for PI, pain, and disability.
• The lesser PI cohort reported superior preoperative PROs and better postoperative anxiety and sleep disturbance outcomes.

Conclusions:

• Greater preoperative PI in lumbar decompression patients may correlate with higher rates of clinically meaningful improvement.
• While lower preoperative PI is associated with better anxiety and sleep, higher PI patients show greater gains in pain and function.
• PROMIS-PI is a valuable tool for stratifying patients and predicting treatment response.