To determine the main risk factors for early postoperative contralateral radicular pain in patients after transforaminal interbody fusion (TLIF) who often suffer from contralateral radicular pain.

Patients who underwent TLIF surgery in the Department of Spinal surgery of Changzhou second people's Hospital affiliated to Nanjing Medical University were collected and divided into asymptomatic group and symptomatic group according to whether they had early contralateral nerve root pain after operation. A total of 170 patients underwent TLIF surgery in our department from January 2020 to January 2022, of which 66 patients met the inclusion and exclusion criteria and 33 patients developed early postoperative contralateral nerve root pain. The patients of the two groups were followed up after operation, the general data and operation-related indexes were collected, and the concentration of inflammatory factors in wound drainage fluid 3 days after operation were compared and analyzed by regression analysis.

Finally, 66 patients were included in the study, and the follow-up time was (26.6±1.1) days. There were 36 males and 30 females with an average age of (66±8) years. Univariate analysis showed that the concentration of PGE2 in drainage fluid in symptom group was lower than that in asymptomatic group, and the concentrations of HIS and BK in drainage fluid in symptom group were higher than those in asymptomatic group. The differences between groups in univariate analysis were included in multivariate regression analysis. The results showed that HIS (OR=4.384) and BK (OR=10.921) in drainage fluid were the influencing factors of contralateral early nerve root pain after TLIF.

The levels of HIS and BK in the drainage fluid of patients after TLIF are independent risk factors for the occurrence of contralateral early nerve root pain, which can be used as a reference basis for managing patients with early contralateral nerve root pain after operation, and provide new ideas for clinical treatment of this kind of patients.