The role of pain trajectory and sex in predicting postoperative neck pain in patients after cervical spine surgery: A retrospective cohort study

Background Postoperative neck pain is common after cervical spine surgery, with potential progression to chronic pain. Objective To assess the role of pain trajectory in predicting postoperative neck pain following cervical spine surgery and to discern sex-based differences in this relationship. Methods A retrospective study was conducted on 133 patients (mean age:64.1 ± 11.9 years; 86 males, 47 females) undergoing cervical spine surgery. Pain trajectory, defined by Numerical Rating Scale scores on postoperative days 1, 3, 5, and 7, was analyzed using hierarchical multiple regression to evaluate its predictive value for neck pain at two weeks, with sex as a moderator. Results Sex (B = 0.613; p < .05), slope (B = 1.528; p < .01), and intercept (B = 0.410; p < .01) were significant predictors. Pain trajectory had a stronger association with neck pain in females (B = 2.283; p < .01) than in males (B = 0.772; p = .03). Conclusion Pain trajectory is a predictor of postoperative neck pain and highlights sex-based differences. Incorporating pain trajectory monitoring into clinical practice can enable the early identification of patients at higher risk for poor pain outcomes, facilitating more targeted and effective interventions.