Observational studyPloS one2018
Prognostic function to estimate the probability of meaningful clinical improvement after surgery - Results of a prospective multicenter observational cohort study on patients with lumbar spinal stenosis.
Observational study in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Prevalence of multimorbid degenerative lumbar spinal stenosis with knee or hip osteoarthritis: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2022Pooled it
- The impact of overall lumbar disc degeneration burden on disability outcomes following surgery for lumbar spinal stenosis due to osteoarthritis.Osteoarthritis and cartilage open · 2026Article
- Impact of sarcopenia and multifidus atrophy on outcomes from minimally invasive decompression surgery for lumbar spinal stenosis.North American Spine Society journal · 2026Article
- Identifying modifiable factors that influence walking in patients undergoing surgery for neurogenic claudication: a prospective longitudinal study.Scientific reports · 2025Article
- Primary Results of Our Protocol for Standardization of Perioperative Antiplatelet Agent Management on the Incidence of Epidural Hematoma and Thrombotic Complications in Posterior Cervical Surgery: A Prospective Cohort Study.Spine surgery and related research · 2024Article
- Biomechanical Evaluation of Spinal Column after Percutaneous Cement Discoplasty: A Finite Element Analysis.Orthopaedic surgery · 2022Article
- Differential Agnostic Effect Size Analysis of Lumbar Stenosis Surgeries.International journal of spine surgery · 2022Article
- Association between depression and anxiety on symptom and function after surgery for lumbar spinal stenosis.Scientific reports · 2022Article
- A Differential Clinical Benefit Examination of Full Lumbar Endoscopy vs Interspinous Process Spacers in the Treatment of Spinal Stenosis: An Effect Size Meta-Analysis of Clinical Outcomes.International journal of spine surgery · 2022Article
- Immunoglobulin signature predicts risk of post-acute COVID-19 syndrome.Nature communications · 2022Article
- Prediction of walking ability following posterior decompression for lumbar spinal stenosis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2021Observational
- The influence of comorbidities on the treatment outcome in symptomatic lumbar spinal stenosis: A systematic review and meta-analysis.North American Spine Society journal · 2021Review
- Development of a model to predict the probability of incurring a complication during spine surgery.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2021Article
- Predicting recovery after lumbar spinal stenosis surgery: A protocol for a historical cohort study using data from the Canadian Spine Outcomes Research Network (CSORN).Canadian journal of pain = Revue canadienne de la douleur · 2020Article
- Patient selection protocols for endoscopic transforaminal, interlaminar, and translaminar decompression of lumbar spinal stenosis.Journal of spine surgery (Hong Kong) · 2020Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundApproximately two thirds of patients with lumbar spinal stenosis (LSS) who undergo surgical treatment benefit from the surgery. The objective of this study was to derive a prognostic probability function (PPF) to identify patients with a high probability of post-surgical improvement because there is currently no method available.
methodsIn this multicenter, prospective, observational study, we collected data from eight medical centers in Switzerland in which patients underwent surgery for LSS. The endpoints were meaningful clinically important differences (MCID) in pain and disability one year after baseline. We developed a PPF named PROCESS (PostopeRative OutComE Spinal Stenosis), based on a large set of prognostic indicators extracted from the literature. The PPF was derived using data from a random subset of two thirds of the patients and validated in the remaining third. We addressed overfitting by shrinking the regression coefficients. The area under the ROC curve (AUC) and calibration determined the accuracy of the PPF.
resultsIn this study, 452 LSS patients received surgery. 73% of the 300 patients in the derivation subset reached an MCID in pain and 68% reached an MCID in disability. The corresponding values were 70% and 63% in the validation subset, respectively. In the derivation subsample, the AUC was 0.64 (95% CI 0.57 to 0.71) for of the PPF predicting MCID in pain and 0.71 (0.64 to 0.77) for MCID in disability, after shrinkage. The corresponding numbers were 0.62 (0.52 to 0.72) and 0.70 (0.60 to 0.79) in the validation subsample, and the PPF showed good calibration.
conclusionsSurgical treatment for patients with lumbar spinal stenosis is being performed with increasing frequency. PROCESS is conditional on the individual pattern of preoperatively available prognostic indicators, and may be helpful for clinicians in counselling patients and in guiding the discussion on individual treatment decision in the era of personalized medicine.
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