General Session: Innovative Technologies I - Hall F

Presented by: B. Mayo


B. Khechen(1), B. Haws(1), A. Narain(1), F. Hijji(1), B. Mayo(1), D. Massel(1), D. Bohl(1), J. Guntin(1), K. Cardinal(1), K. Singh(1)

(1) Rush University Medical Center, Orthopaedic Surgery, Chicago, IL, United States


Background information: With an increasing focus on patient satisfaction, limiting patient pain has become a primary focus for hospitals and physicians alike. The risk factors for increased inpatient pain scores following minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) have not been well described in the literature.

Objective: To describe the risk factors for higher inpatient pain scores following MIS TLIF.

Methods: A prospectively maintained surgical database of patients who underwent a primary, 1-level TLIF for degenerative spinal pathology between 2010-2015 was reviewed. Both bivariate and stepwise multivariate Poisson regression with robust error variance were used to assess risk factors for average inpatient pain score ≥ 5.0. Potential risk factors included demographic, comorbidity, and procedural characteristics.

Results: A total of 255 patients were included in this analysis. On bivariate regression, younger age (RR=1.55; p< 0.001), workers' compensation (RR=1.88; p< 0.001), preoperative pain score ≥ 7.0 (RR=1.42; p=0.012), and operative time longer than 110 minutes (RR=1.44; p=0.003) were found to be associated with elevated inpatient pain scores. On multivariate stepwise regression, younger age (RR=1.37; p=0.013), workers' compensation (RR=1.59; p=0.001), preoperative visual analogue scale (VAS) pain score ≥ 7.0 (RR=1.29; p=0.045), and operative time longer than 110 minutes (RR=1.36; p=0.015), were found to be independently associated with an average inpatient pain score ≥ 5.0.

Conclusions: The results of this study suggest that younger age, workers' compensation, elevated preoperative pain scores, and longer operative times are independently associated with greater inpatient pain following TLIF. Surgeons can use this information to better assess which patients may require additional pain control following TLIF. Further studies are needed to determine specific characteristics about these populations that lead to higher pain scores.

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