• Akihiko Hiyama, Hiroyuki Katoh, Satoshi Nomura, Daisuke Sakai, and Masahiko Watanabe.
• Department of Orthopaedic Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan. Electronic address: a.hiyama@tokai-u.jp.
• World Neurosurg. 2022 Aug 1; 164: e814-e823.

ObjectiveThe purpose of this study was to analyze whether the type of preoperative pain affects the improvement in postoperative pain intensity in patients with a lumbar degenerative disease (LDD).MethodsWe retrospectively reviewed 93 patients who underwent lateral lumbar interbody fusion (LLIF) without direct decompression. All patients were evaluated using Numeric Rating Scale (NRS) scores for low back pain (NRSLBP), leg pain (NRSLP), and leg numbness (NRSLN) and imaging data before and after LLIF surgery. Based on the Japanese version of the painDETECT scores, patients were classified into 3 groups: a neuropathic pain (NeP) group, a nociceptive pain (NocP) group, and an intermediate mixed pain group.ResultsThe Japanese version of the painDETECT identified NeP in 20.4% of patients with LDD prior to LLIF. Preoperative NRSLBP, NRSLP, and NRSLN scores were higher in the NeP group than those in the NocP group. All types of pain improved after LLIF surgery. The NRSLBP score 12 months after surgery was higher in the NeP group (3.8 ± 2.8) than that in the NocP group (1.9 ± 2.2) (P = 0.008). Similar results were obtained with NRSLP (NeP group = 3.1 ± 2.8, NocP group = 1.5 ± 2.0, P = 0.010).ConclusionsAlthough LLIF was useful for relieving all types of preoperative pain in LDD patients, the NRS scores for preoperative pain were higher in the NeP group than those in the NocP group, and the postoperative NRSLBP and NRSLP score was significantly higher in the NeP group. Thus, controlling preoperative NeP may improve therapeutic efficacy.Copyright © 2022 Elsevier Inc. All rights reserved.

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