Predicted time for radicular pain relief after microsurgical lumbar spinal nerve root decompression

Abstract Background The exact time frame for RP relief following surgery and clinical, radiological and neurophysiological predictors of pain persistence after surgery are not clear. Results Complete resolution of RP following MDSR was observed in 50 (86%) patients, with 24 (48%) reporting no pain on the first postoperative day. RP persisted for up to 4 weeks in 16 (32%) patients, up to 6 weeks in two (4%), and up to 8 and 12 weeks in four (8%). Sensory loss before surgery is a major adverse factor. Preoperative RP severity also played a negative role. However, paramedian herniation and a longer duration of the disease were associated with a shorter time to pain relief. Based on Fisher’s Linear Discriminant Analysis (FLDA) results, sex, age, extent of FI of the PM, and ODI (Oswestry Disability Index) score before surgery did not influence the outcome. Conclusions In an overwhelming majority of cases, RP is completely resolved within the first 4 weeks following MDSR. The paramedian type of IVD herniation is the most favorable for RP relief. Sensory loss and severe pain before surgery result in persistent RP after MDSR. The time to RP relief in patients with identified EMG neurogenic findings in the PM was significantly shorter.