Abstract: Objective  To investigate the association between recurrent low back pain(RLBP) and postoperative weight gain(PWG) after recurrent low back pain(TLIF) at three-month follow-up.Methods  We analyzed 254 patients at three-month after TLIF from September 2020 to September 2022.Data such as age, gender, height and weight before surgery, smoking status, Pfirrmann grade of preoperative intervertebral disc degeneration, visual analogue scale (VAS) before surgery and 7 days, 1 month and 2 months after surgery were collected.RLBP was defined for patients with low back pain with VAS score ≤3 on the 7th, 1st and 2nd month after surgery, but ≥4 on the 3rd month after surgery.Three months after surgery, PWG was divided into 4 groups: <0kg group, 0~<5kg group, 5~<10kg group, and ≥10kg group. Multivariate Logistic regression analysis of odds ratio (ORs).Results The prevalence of persistent RLBP was 18.5%(n=47).Compared to patients with a PWG of <0 kg,patients with a PWG of 5 kg to <10 kg and ≥10 kg had a higher prevalence of RLBP(OR=2.48 and 4.19,respectively);the difference was statistically significant (P<0.05).However,no significant difference was found for patients with a PWG of 0 kg to <5 kg.In addition,Logistic regression analysis also showed female,higher preoperative body mass index(BMI) and higher preoperative Pfirrmann grade were other three independent risk factors of RLBP.Conclusion  PWG in TLIF patients is one of the independent risk factors for RLBP. Postoperative weight intervention for patients can reduce the incidence of RLBP and improve patient satisfaction with the surgery.

Key words: transforaminal lumbar interbody fusion, recurrent low back pain, postoperative weight gain, risk factor