Bouncing back after lumbar spine surgery: early postoperative resilience is associated with 12-month physical function, pain interference, social participation, and disability

Coronado, Rogelio A.; Robinette, Payton E.; Henry, Abigail L.; Pennings, Jacquelyn S.; Haug, Christine; Skolasky, Richard L.; Riley, Lee H.; Neuman, Brian J.; Cheng, Joseph; Aaronson, Oran S.; Devin, Clinton J.; Wegener, Stephen T.; Archer, Kristin R.

doi:10.1016/j.spinee.2020.07.013

Cited by 24 publications

(27 citation statements)

References 63 publications

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“…Outside of joint arthroplasty, Coronado et al found that resilience had an independent effect on patient's 12 month PF, pain interreference, social participation, and disability scores in patients undergoing laminectomy with and without fusion. 37 Compared with our results, the previous study found a slightly smaller correlation of resilience with PROMIS PF (r = 0.37 versus 0.43) and larger correlation of resilience with PROMIS PI (r = −0.41 versus −0.38). These results are largely comparable despite extremely different patient populations and surgical interventions.…”

Section: Discussioncontrasting

confidence: 99%

“… 7 Multiple studies have now highlighted the role resilience plays in the outcomes of patients undergoing orthopaedic surgery ranging from upper extremity arthroplasty to hip fracture repair and spine procedures. 4 , 5 , 7 , 36 , 37 This is the first study to date to demonstrate the impact of resilience on the outcomes of lateral ligament repair and more generally the field of foot and ankle surgery. Tokish et al was the first to investigate the role of resilience, as measured by the BRS, within the field of orthopaedics and demonstrate its impact on patients undergoing total shoulder arthroplasty.…”

Section: Discussionmentioning

confidence: 95%

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Impact of Patient Resilience on Outcomes of Open Brostrom-Gould Lateral Ligament Repair

et al. 2021

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Introduction: Little is known about the factors affecting the intermediate outcomes of the Brostrom-Gould repair as measured by new patient-reported outcome instruments and the impact of patient resilience on postoperative outcomes. This is the first study to investigate the impact of resilience on the outcomes of lateral ligament repair. Methods: Retrospectively, 173 patients undergoing Brostrom-Gould at single institution from January 2013 to June 2020 were identified. Patient characteristics, participation in athletic activities, surgical variables, and complications were recorded. Patient-Reported Outcome Measurement Information System (PROMIS) Pain Interference v1.1 (PI), Physical Function v1.2 (PF), and the Foot Ankle Ability Measure (FAAM) were collected. The Brief Resilience Scale was used to quantify resilience. A linear regression model was constructed to evaluate the independent effect of resilience on each PROMIS and FAAM outcome instrument. Variables were included in the regression model based on an a priori significance threshold of P <0.05 in bivariate analysis. Results: Resilience's independent effect on outcome measures was as follows: PROMIS PF (unstandardized β 8.2, 95% confidence interval [CI] 3.9 to 12.6), PROMIS PI (unstandardized β −4.8, 95% CI −7.9 to −1.7), FAAM Activities of Daily Living (unstandardized β 16.6, 95% CI 8.7 to 24.6), and FAAM Sports (unstandardized β 28.4, 95% CI 15.9 to 40.9). Preoperative participation in athletic activities also had a positive independent effect on multiple outcome metrics including PROMIS PF (unstandardized β 9.4, 95% CI 2.8 to 16.0), PROMIS PI (unstandardized β −5.3, 95% CI −10.0 to −0.582), and FAAM Sport scores (unstandardized β 34.4, 95% CI 15.4 to 53.4). Conclusions: Resilience and patient participation in athletic activities are independent predictors of improved postoperative functional outcomes as measured by PROMIS and FAAM instruments at intermediate term follow-up. Resilient patients and athletes reported markedly higher PF and less pain burden postoperatively. Preoperative quantification of resilience could enable improved prognostication of patients undergoing lateral ligament repair of the ankle.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 95%

Impact of Patient Resilience on Outcomes of Open Brostrom-Gould Lateral Ligament Repair

et al. 2021

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“…Most studies included in the review ( n = 15) reported that higher resilience was associated with lower MEP or greater physical function after a musculoskeletal injury. These findings were observed across a range of functional outcome measures and amongst a range of participant groups (Additional File 3 ), including those recovering from surgery [ 16 , 33 ] or experiencing ongoing musculoskeletal pain [ 34 – 36 ]. Whilst inconclusive findings were often observed amongst common injury presentations, all articles examining participants after reverse total shoulder arthroplasty [ 37 , 38 ] and hip fracture [ 39 – 41 ] reported consistent findings in support of resilience.…”

Section: Resultsmentioning

confidence: 90%

A scoping review on the methods of assessment and role of resilience on function and movement-evoked pain when experiencing a musculoskeletal injury

Robinson

Clothier

Slater

et al. 2022

BMC Musculoskelet Disord

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Background Resilience refers to an individual’s ability to maintain effective functioning, by resisting, withstanding or recovering from stressors or adversity, including pain associated with physical injury (J Clin Psychol Med Settings 28:518–28, 2021). The aim of this scoping review is to determine the role of resilience in the experience of movement-evoked pain (MEP) and return to functional activity following a musculoskeletal injury. Methods This review conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews and the scoping review protocol of the Joanna Briggs Institute (JBI). Five databases and one grey literature database were searched using predetermined key words and index terms to capture published and unpublished records on the topic. Two authors independently screened the title and abstract of each record, with the full-text of eligible records being reviewed. Papers were eligible for inclusion if they examined the population, concept and context of interest, were written in English and the full text was available. Data were extracted from each eligible record to guide discussion of the available literature on this topic. Results Of 4771 records, 2695 articles underwent screening based on their title and abstract. After title and abstract screening 132 articles were eligible for full text review, with 24 articles included in the final analysis. This review identified that psychological resilience has primarily been investigated in the context of a range of age-related pathologies. The choice of functional and movement-evoked pain assessments in the included studies were often guided by the pathology of interest, with some being general or injury specific. Conclusion This scoping review identified inconsistent conclusions regarding the role of resilience in the experience of MEP and the ability to return to function for older adults with a musculoskeletal injury. This scoping review highlights the need for longitudinal research to be conducted that allows a broader age range, including younger adults, to determine if multidimensional resilience may promote recovery form musculoskeletal injury.

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“…Based on this research, values of RBCs <4 10 6 /μl and of Hb <12 g/dl in both genders may be associated with excessive rates of long-term failure after spine surgery from a patient's perspective. However, the model is not reliable in its current form and should be integrated with multidimensional variables of demographic, laboratory, and clinical nature to investigate further recovery determinants, such as body weight ( 36 ), the psychological distress ( 37 ), or the propensity for postoperative movement ( 38 ) and social participation ( 39 ). The ideal predictive model should have both high sensitivity and low false-positive rates.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Long-Term Recovery From Disability Using Hemoglobin-Based Models: Results From a Cohort of 1,392 Patients Undergoing Spine Surgery

et al. 2022

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Hemoglobin and its associated blood values are important laboratory biomarkers that mirror the strength of constitution of patients undergoing spine surgery. Along with the clinical determinants available during the preadmission visit, it is important to explore their potential for predicting clinical success from the patient's perspective in order to make the pre-admission visit more patient-centered. We analyzed data from 1,392 patients with spine deformity, disc disease, or spondylolisthesis enrolled between 2016 and 2019 in our institutional Spine Registry. Patient-reported outcome measure at 17 months after surgery was referred to the Oswestry disability index. High preoperative hemoglobin was found to be the strongest biochemical determinant of clinical success along with high red blood cells count, while low baseline disability, prolonged hospitalization, and long surgical times were associated with poor recovery. The neural network model of these predictors showed a fair diagnostic performance, having an area under the curve of 0.726 and a sensitivity of 86.79%. However, the specificity of the model was 15.15%, thus providing to be unreliable in forecasting poor patient-reported outcomes. In conclusion, preoperative hemoglobin may be one of the key biomarkers on which to build appropriate predictive models of long-term recovery after spine surgery, but it is necessary to include multidimensional variables in the models to increase the reliability at the patient's level.

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Bouncing back after lumbar spine surgery: early postoperative resilience is associated with 12-month physical function, pain interference, social participation, and disability

Cited by 24 publications

References 63 publications

Impact of Patient Resilience on Outcomes of Open Brostrom-Gould Lateral Ligament Repair

Impact of Patient Resilience on Outcomes of Open Brostrom-Gould Lateral Ligament Repair

A scoping review on the methods of assessment and role of resilience on function and movement-evoked pain when experiencing a musculoskeletal injury

Prediction of Long-Term Recovery From Disability Using Hemoglobin-Based Models: Results From a Cohort of 1,392 Patients Undergoing Spine Surgery

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