Introduction: Many patients complained of residual symptoms following lumbar decompressive surgery. However, few studies analyze this dissatisfaction by focusing on preoperative patients’ symptoms. Therefore, we designed this study to determine the factors that could predict the patients’ postoperative complaints by focusing on their preoperative symptoms. 

Methods: Four hundred and sixty-nine consecutive patients who underwent lumbar decompression and fusion surgery for lumbar degenerative disease (LDD) were included. Postoperative complaint was defined by at least twice same complaint during the outpatient follow-up of 3,6,12, and 24 months after surgery. A comparative analysis was performed between complaint group (group C, n = 250) and non-complaint group (group NC, n = 219). Preoperative and postoperative chief complaints were analyzed through chart review. Demographic, operative, symptomatic, and clinical factors were compared between the groups by univariate and multivariate analyses.

Results: Most common postoperative complaint was residual radiating pain (36.0%, n = 90) followed by tingling sensation (23.6%, n = 59). The presence of psychotic disease (odds ratio [OR], 4.666; p = 0.019), longer pain duration (OR, 1.021; p < 0.001), pain to below the knee (OR, 2.326; p = 0.001), preoperative tingling sensation (OR, 2.631; p < 0.001), preoperative sensory and motor power decrease (OR, 2.152 and 1.678; p = 0,047 and 0.007, respectively) were significantly correlated with postoperative patients’ complaints in multivariate analysis.

Conclusions: Base on the current study, the postoperative patients’ complaints could be predicted and explained in advance by checking the preoperative characteristics of patients’ symptoms, including the duration and site carefully. This could be helpful to enhance the understanding of the surgical results preoperatively, which could control the anticipation of the patients.

Figure: Comparisons of preoperative and postoperative patients’ chief complaints