The patients undergoing lumbar spine surgery expects pain relief. This study was performed to investiagate the 2-year postoperative pain and to determine whether this outcome varied as per the patient and clinical characteristics, encompassing amount of pain relief expected preoperatively.

A total of 422 patients, before surgery patients completed valid questionnaires that addressed clinical characteristics and expectations for pain improvement. After two years of surgery, the patients explained how much pain improvement they actually received.

Mean age  was 56 years old and 55% were men. Out of these, 11% of patients reported no improvement in pain, 28% reported a little to moderate improvement, 44% reported a lot of improvement, and 17% reported complete improvement two years after surgery.

The patients detailed less pain improvement if, before surgery, they expected greater pain improvement (odds ratio [OR] 1.4), had a positive screen for depression (OR 1.7), were having revision surgery (OR 1.6), had surgery at L4 or L5 (OR 2.5), had a degenerative diagnosis (OR 1.6), and if, after surgery, they had another surgery (OR 2.8) and greater back (OR 1.3) and leg (OR 1.1) pain (all variables P≤0.05) in multivariable analysis.

Pain is common after lumbar surgery and is concerned with a network of clinical, surgical, and psychological variables. The patients’ expectations about pain are an independent variable in this network as was concluded from this study. This study supports addressing pain-related expectations with patients before surgery via discussions with surgeons and through formal preoperative patient education as the expectations are potentially modifiable.