Impact of Postoperative Chronic Back Pain Syndrome on the Incidence of Psychiatric and Brain Disorders, and All-Cause Mortality
J Pain Res. 2026 Feb 11;19:582506. doi: 10.2147/JPR.S582506. eCollection 2026.
ABSTRACT
PURPOSE: Postoperative chronic back pain syndrome (PCBPS) is characterized by persistent or recurrent symptoms following lumbar spine surgery. This study aimed to investigate its long-term associations with psychiatric and brain disorders, and mortality outcomes.
PATIENTS AND METHODS: This retrospective cohort study utilized the Korean National Health Insurance Service database. Patients who underwent lumbar spinal surgery between 2009 and 2023 were included (n= 603,272). PCBPS was operationally defined using three criteria: diagnosis code for post-laminectomy syndrome (PCBPS-D group), prolonged gabapentinoid prescription (≥12 weeks) (PCBPS-G group), and reoperation (PCBPS-R group). Psychiatric disorders (anxiety, depression, and insomnia), brain disorders (stroke, Parkinson's disease, and dementia), and all-cause mortality were assessed as outcomes.
RESULTS: Among the cohort, 169,796 patients (28.1%) met at least one PCBPS definition. PCBPS was significantly associated with psychiatric disorders (aHR 1.15; 95% CI, 1.13-1.17), including anxiety (aHR 1.15; 95% CI, 1.11-1.19), depression (aHR 1.20; 95% CI, 1.15-1.24), and insomnia (aHR 1.14; 95% CI, 1.11-1.18). PCBPS was also linked to increased risk of brain disorders (aHR 1.09; 95% CI, 1.07-1.11), including stroke (aHR 1.15; 95% CI, 1.12-1.19), Parkinson's disease (aHR 1.40; 95% CI, 1.27-1.55), and dementia (aHR 1.07; 95% CI, 1.05-1.09). Moreover, PCBPS was associated with higher all-cause mortality (aHR 1.10; 95% CI, 1.07-1.12). These associations remained robust across PCBPS sub-definitions and stratified analyses.
CONCLUSION: PCBPS is associated with increased risks of psychiatric disorders, brain diseases, and mortality. These findings emphasize the need for early identification and integrative management in patients with chronic postsurgical pain.
PMID:41710284 | PMC:PMC12912100 | DOI:10.2147/JPR.S582506