Effect of preoperative symptom duration on outcome in lumbar spinal stenosis: a Canadian Spine Outcomes and Research Network registry study

Predictors of Pain and Disability Outcomes Following Spinal Surgery for Chronic Low Back and Radicular Pain

“…Seventeen included reports based on 14 studies examined predictors of disability outcomes in 15 patient cohorts (6899 participants in total). Several studies measured disability (or physical functioning) using ODI,50–52,55,57,60–63,65,66 SF-36 Physical Functioning (PF) subscale,50,51,58,61–63 SF-12 Physical Component Summary (PCS),52,55 and RMDQ 54,64. There were also single studies using COMI,10 PROMIS Physical Function (PF) subscale,52 Disability Rating Index,56 and Barthel Index 49.…”

“…There were also single studies using COMI,10 PROMIS Physical Function (PF) subscale,52 Disability Rating Index,56 and Barthel Index 49. Ten studies assessed change in disability as a continuous outcome,10,49–52,55–58,61–64 and 5 studies as a dichotomous one. The latter defined clinically significant improvement as 30% (RMDQ, ODI54,65), 50% (ODI60), 17/100 points (ODI66), or 2/10 points (COMI10) reduction in disability from preoperative baseline to postoperative follow-up.…”

“…We included only the last available follow-up, unless eligible analysis was only conducted for an earlier time point. 55 Note that Gepstein et al 49 analyzed 2 ethnic groups separately, which we consider to be 2 cohorts, whereas 2 reports from Kim et al 50,51 appear to be based on 2 largely overlapping populations, thus we attribute these results to a single study cohort in this review. Three other reports [61][62][63] were classified as post hoc subgroup analyses of 1 interventional study, and since each report conducted separate analyses on spinal stenosis and degenerative spondylolisthesis subgroups, these are considered as 2 unique cohorts in the current review.…”

“…Most studies measured pain using 0 to 10 VAS 9,[49][50][51]54 or Numerical Rating Scale, 10,55,59 however, 0 to 100 VAS 11,52,53,57,58 and Pain Index 56 scales were also used. Ten studies assessed change in pain intensity as a continuous outcome, 10,11,[49][50][51][52][53][55][56][57][58] and 5 studies as a dichotomous one. The latter defined clinically significant improvement as 30%, 54,59 70%, 9 18/100 points, 11 or 2/10 points 10 reduction in pain from preoperative baseline to postoperative follow-up.…”

“…The latter defined clinically significant improvement as 30%, 54,59 70%, 9 18/100 points, 11 or 2/10 points 10 reduction in pain from preoperative baseline to postoperative follow-up. Change in leg and back pain were examined as separate outcomes in 6 studies, 10,11,[50][51][52]57,58 2 considered leg pain alone, 53,55 and 5 assessed pain in general. 9,49,54,56,59 Supplementary Table 3 (Supplemental Digital Content 10, http:// links.lww.com/CJP/A871) presents the results for each of these outcomes separately, however, since the within-study findings were largely consistent across back and leg pain outcomes, in the narrative synthesis we refer to change in pain intensity in general as a single outcome.…”