The risk factors of chronic low back pain after surgery for lumbar degenerative disease in female patients

English Keywords:Chronic low back pain  Risk factor  Postoperative lumbar degenerative disease  Peri-menopausal period  Perimenopausal syndrome

English Abstract:

  【Abstract】 Objectives: To investigate whether peri-menopausal period is an independent risk factor for chronic low back pain after surgery for lumbar degenerative disease. Methods: From January 2014 to September 2016, female patients who diagnosed as lumbar disc herniation and degenerative lumbar canal stenosis underwent discectomy or posterior lumbar interbody fusion or transforaminal lumbar interbody fusion surgery were included in our study. Risk factors for chronic low back pain including age, body mass index(BMI), basic diseases, preoperative chronic low back pain, preoperative leg pain, VAS score of low back pain and leg pain, preoperative lumbar JOA score, operation method, number of surgery segment, surgery segment, operator, operation time, blood loss, peri-menopausal period and premenopausal syndrome were investigated in our study. All risk factors were analyzed with single factor logistic regression analysis, multiplicity logistic regression analysis and propensity score matching(PSM) respectively. Data were analyzed with SPSS 22.0. P<0.05 was found to be statistically significant. Results: Among 178 female patients, 147 cases were followed up successfully and 31 cases were lost, the follow-up rate was 82.58%. The follow-up time between 6 and 39 months, mean follow-up time was 19.14±9.33 months. The age ranged from 19 to 77 years old, the average age was 49.68±11.76 years. There were 63 cases with peri-menopausal period(42.86%) and 33 patients with perimenopausal period syndrome(22.45%). 53 cases underwent chronic low back pain(36.05%). The single factor logistic analysis showed that the risk factors associated with chronic low back pain were BMI, preoperative chronic low back pain, operation time, blood loss, peri-menopausal period and perimenopausal syndrome(P<0.05). The multivariate logistic analysis showed that independent risk factors associated with chronic low back pain of lumbar degenerative disease surgery were preoperative chronic low back pain, perimenopausal and menopausal syndrome. The PSM analysis showed that there was statistically significant(P<0.05) between the study group(group of peri-menopausal period) and control group(group of non peri-menopausal period) in the incidence of chronic low back pain. There was no statistically significant(P>0.05) between group A(patients with perimenopausal syndrome) and group B(patients without perimenopausal syndrome) in the incidence of chronic low back pain. Conclusions: For female patients, peri-menopausal period is an independent risk factor for chronic low back pain complicated by postoperative lumbar degenerative disease; BMI, preoperative chronic low back pain, operation time, intra-operative blood loss and perimenopausal syndrome are risk factors for chronic low back pain complicated by postoperative lumbar degenerative disease.