title: The Course of Pain Intensity in Patients Undergoing Herniated Disc Surgery: A 5-Year Longitudinal Observational Study.
abstract: OBJECTIVE
  The aims of this study are to answer the following questions (1) How does the pain intensity of lumbar and cervical disc surgery patients change within a postoperative time frame of 5 years? (2) Which sociodemographic, medical, work-related, and psychological factors are associated with postoperative pain in lumbar and cervical disc surgery patients?
  
  
  METHODS
  The baseline survey (T0; n = 534) was conducted 3.6 days (SD 2.48) post-surgery in the form of face-to-face interviews. The follow-up interviews were conducted 3 months (T1; n = 486 patients), 9 months (T2; n = 457), 15 months (T3; n = 438), and 5 years (T4; n = 404) post-surgery. Pain intensity was measured on a numeric rating-scale (NRS 0-100). Estimated changes to and influences on postoperative pain by random effects were accounted by regression models.
  
  
  RESULTS
  Average pain decreased continuously over time in patients with lumbar herniated disc (Wald Chi² = 25.97, p<0.001). In patients with cervical herniated disc a reduction of pain was observed, albeit not significant (Chi² = 7.02, p = 0.135). Two predictors were associated with postoperative pain in lumbar and cervical disc surgery patients: the subjective prognosis of gainful employment (p<0.001) and depression (p<0.001).
  
  
  CONCLUSIONS
  In the majority of disc surgery patients, a long-term reduction of pain was observed. Cervical surgery patients seemed to benefit less from surgery than the lumbar surgery patients. A negative subjective prognosis of gainful employment and stronger depressive symptoms were associated with postoperative pain. The findings may promote multimodal rehabilitation concepts including psychological and work-related support.
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
authors.forename: Marie
authors.initials: M
authors.lastname: Dorow
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
authors.forename: Margrit
authors.initials: M
authors.lastname: Löbner
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
authors.forename: Janine
authors.initials: J
authors.lastname: Stein
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Pabst
authors.affiliation: Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Konnopka
authors.affiliation: Department of Neurosurgery, Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle (Saale), Germany.
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Meisel
authors.affiliation: Department of Neurosurgery, Klinikum St. Georg gGmbH, Leipzig, Germany.
authors.forename: Lutz
authors.initials: L
authors.lastname: Günther
authors.affiliation: Department of Neurosurgery, University of Leipzig, Leipzig, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Meixensberger
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany.
authors.forename: Katarina
authors.initials: K
authors.lastname: Stengler
authors.affiliation: Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
authors.forename: Steffi G
authors.initials: SG
authors.lastname: Riedel-Heller
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D002574:Cervical Vertebrae / Q000601:surgery*; D003863:Depression / Q000523:psychology; D004185:Disability Evaluation; D017586:Diskectomy; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008137:Longitudinal Studies; D008159:Lumbar Vertebrae / Q000601:surgery*; D008161:Lumbosacral Region / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology* / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult