Duration of aggravated symptoms affects satisfaction after degenerative lumbar surgery.

PURPOSE: To identify how symptom duration of aggravated symptoms prior to surgery impacts patient satisfaction for LSS fusion surgery and to determine the threshold point for unsatisfactory results.

METHODS

A retrospective review of 132 patients who underwent lumbar fusion surgery for degenerative LSS between January 2021 and December 2023 was conducted. Patient satisfaction was evaluated using a 4-point Likert scale at minimum one-year follow-up. PROMs such as VAS, ODI, and PainDetect scores, were also collected. The patients were divided into satisfactory and unsatisfactory groups. Multiple variables, including demographics, and radiological findings, were analyzed for their correlation with patient satisfaction.

RESULTS

Among 132 patients, 70.4% reported satisfaction with surgical outcomes (51.5% were very satisfied, 18.9% were satisfied). The satisfied group showed significantly shorter duration of aggravated symptoms compared to the unsatisfied group (10.30 ± 9.47 vs. 19.7 ± 14.60 months, p < 0.001). The satisfied group was younger and had lower PainDETECT scores. The satisfaction rates declined markedly after 12 months of symptom duration. Multivariate analysis confirmed prolonged symptom duration, older age and higher PainDetect scores were risk factors for unsatisfactory results.

CONCLUSION

In our study, 70.4% of patients who underwent short level lumbar fusion surgery for degenerative LSS were satisfied with the treatment. Additionally, we identified that longer duration of aggravated symptoms (particularly beyond 12 months), advanced age, and severity of neuropathic pain were risk factors for lower satisfaction rates. It can be suggested that timely surgical intervention, before the progression of neuropathic pain and development of age-related comorbidities, can provide better patient satisfaction outcomes.