Impact of postoperative pain on patient satisfaction and quality of life after surgery for thoracic OPLL and OLF

Surgical treatment for thoracic ossification of the posterior longitudinal ligament (OPLL) and ligamentum flavum (OLF) is effective but carries risks, and its impact on long-term quality of life (QOL) and satisfaction remains unclear. This study evaluated postoperative outcomes, including pain management, QOL, and treatment satisfaction, in patients undergoing thoracic ligament ossification surgery. This retrospective study included patients who underwent surgery for thoracic OPLL or OLF and were followed for over a year. Patient demographics, clinical and imaging findings, and postoperative outcomes were collected. Outcomes were assessed using the Japanese Orthopaedic Association (JOA) score, Pain Detection Score, Numerical Rating Scale (NRS), and EuroQoL 5-Dimension 5-Level (EQ-5D-5L). Among 118 patients analyzed, postoperative improvements in JOA, EQ-5D-5L, and pain-related indices were observed. Satisfaction correlated strongly with pain satisfaction, EQ-5D-5L, and NRS scores. Receiver operating characteristic (ROC) analysis identified an NRS score of 3.5 as the cut-off for significant neuropathic pain. Patients with NRS ≥ 4 reported lower satisfaction and QOL, with more preoperative MRI signal changes. In conclusion, effective pain management, particularly addressing neuropathic pain, is crucial for improving QOL and satisfaction after thoracic ligament ossification surgery. Enhanced pain control and functional recovery are key to achieving better outcomes.