Exploring the Interplay Between Chronic Pain and Neurosurgical Treatment: Predictors of Success in Spinal Surgery

Abstract

Background: Chronic pain related to spinal disorders presents a major challenge in the field of neurosurgery, influencing surgical outcomes and patient recovery. Objective: This study aims to investigate the interplay between chronic pain and neurosurgical treatment, identifying predictors of success and understanding their significance in spinal surgery outcomes. Methods: A retrospective cohort study was conducted involving 168 patients who underwent spinal surgery at the Department of Neurosurgery, University of Wisconsin, Madison, from January 2023 to June 2024. Data were collected on preoperative pain intensity, psychological status, comorbidities, surgical technique, and postoperative pain outcomes. Standardized pain scales (VAS), psychological assessments, and preoperative imaging were used for evaluation. Statistical analyses, including t-tests and linear regression models, were performed to assess the correlation between variables and surgical success. Results: Of the 168 patients, 56% reported significant postoperative pain relief, while 44% experienced persistent or exacerbated pain. The mean preoperative pain intensity (VAS score) was 8.2 ± 1.4, and the postoperative score was 4.3 ± 2.2 (p < 0.01). Psychological distress was a strong predictor of postoperative outcomes, with 62% of patients with high depression scores (PHQ-9 ≥ 15) experiencing poor outcomes (p < 0.005). Age, comorbidities, and preoperative pain intensity also significantly influenced outcomes (p < 0.01). The surgical technique, including minimally invasive procedures, had no significant impact on the primary outcome (p = 0.23). Conclusion: The study confirms that psychological factors, preoperative pain levels, and comorbidities are strong predictors of success in spinal surgery for chronic pain. Early identification of these factors can guide treatment strategies.