Speakers

Chronic Low Back Sng-Pain and Acidosis-evoked Sng: the fMRI study
1110 13:10-13:20
Functional Neurosurgery & Epilepsy/304A
Sng is frequently observed in patients with lumbar radiculopathy and osteoporotic vertebral compression fractures after operation. This study investigates the chronicity of sng in these two distinct clinical conditions and explores potential underlying mechanisms, including the involvement of large-diameter afferent injury in lumbar radiculopathy and osteoclast activity in osteoporotic vertebral compression fractures. Furthermore, this study highlights the significance of sng as a dominant and important symptom associated with the success of operative interventions in both lumbar radiculopathy and osteoporotic vertebral compression fractures.

Later stenosis affects operation success and pain chronicity in lumbar radiculopathy
1109 10:15-10:25
Spine/304A
Low-back pain (LBP) is a leading cause of disability worldwide, projected to affect 843 million people by 2050. Degenerative lumbar spine diseases (DLSD) are the most common cause of chronic LBP, with about 20% of affected individuals requiring surgical intervention as a last resort. Despite this, a substantial number of patients remain unsatisfied with their surgical outcomes. The minimal clinically important difference (MCID) is a critical threshold for assessing treatment efficacy, based on patient-reported outcomes like the Oswestry Disability Index (ODI) and Short Form Health Survey (SF-36). This longitudinal cohort study analyzed data from patients who underwent lumbar spine surgery (LSS) for DLSD at two hospitals in Taiwan from June 2016 to June 2023. Patients were evaluated based on pre-operative and one-year post-operative metrics, including age, body mass index (BMI), modified Charlson Comorbidity Index (mCCI), ODI, SF-36, and Visual Analog Scale (VAS) scores. The primary aim was to identify demographic and clinical predictors of MCID non-achievement. Among the 215 patients included, 15.3% (33 patients) did not achieve MCID. Factors significantly associated with non-achievement included older age, higher comorbidity burden, higher preoperative ODI scores, lower preoperative SF-36 physical component summary (PCS) scores, and presence of postoperative symptoms such as leg soreness, back pain, and leg pain. Notably, 84.8% of the non-MCID group experienced chronic postsurgical pain, characterized by a Visual Analog Scale (VAS) score of ≥ 3 for soreness (sng). Specifically, multivariate analysis revealed that higher preoperative ODI scores decreased the likelihood of achieving MCID (OR=1.07, p=0.002), while higher postoperative mental health scores increased the odds of achieving MCID (OR=1.10, p=0.002). Lower postoperative leg soreness was also strongly associated with MCID achievement (OR=0.778, p=0.016). Persistent postoperative soreness was identified as a major factor for MCID non-achievement, with 27.3% of these patients suffering from persistent leg and back pain, and 21.2% having recurrence and complications. Animal models studying pain chronicity in lumbar radiculopathy have provided insights that may guide future management strategies. These models emphasize the complex interplay of neurobiological processes in chronic pain, suggesting that targeted interventions addressing both physical and psychological aspects of pain could enhance patient outcomes. This study underscores the importance of preoperative disability and postoperative mental health in determining surgical outcomes, suggesting that careful patient selection and targeted post-operative management could improve the likelihood of achieving MCID.