Preoperative Low Back Pain Affects Postoperative Patient Satisfaction Following Minimally Invasive Transforaminal Lumbar Interbody Fusion Surgery

Study Design: A single-center retrospective study. Purpose: To research the predictive factors associated with postoperative patient satisfaction 1 year after minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), a minimally invasive procedure for lumbar degenerative disease. Overview of Literature: There have been reports of numerous variables influencing patient satisfaction with lumbar surgery; however, there have been few investigations on MIS are limited. Methods: This study included 229 patients (107 men and 122 women; mean age, 68.9 years) who received one or two levels of MIS-TLIF, and the patient's age, gender, disease, paralysis, preoperative physical functions, duration of symptom(s), and surgery-associated factors (waiting for surgery, number of surgical levels, surgical time, and intraoperative blood loss) were studied. Radiographic characteristics and clinical outcomes such as Oswestry Disability Index (ODI) scores and Visual Analog Scale (VAS; 0-100) ODI scores for low back pain, leg pain, and numbness were studied. One year following surgery, patient satisfaction (defined as satisfaction for surgery and for present condition; 0-100) was assessed using VAS and its relationships with investigation factors were examined. Results: The mean VAS scores of satisfaction for surgery and for present condition were 88.6 and 84.2, respectively. The results of multiple regression analysis showed that preoperative adverse factors of satisfaction for surgery were being elderly (beta=-0.17, p=0.023), high preoperative low back pain VAS scores (beta=-0.15, p=0.020), and postoperative adverse factors were high postoperative ODI scores (beta=-0.43, p<0.001). In addition, the preoperative adverse factor of satisfaction for present condition was high preoperative low back pain VAS scores (beta=-0.21, p=0.002), and postoperative adverse factors were high postoperative ODI scores (beta=-0.45, p<0.001) and high postoperative low back pain VAS scores (beta=-0.26, p=0.001). Conclusions: According to this study, significant preoperative low back pain and high postoperative ODI score after surgery are linked to patient unhappiness.