ArticlePloS one2019
Patients undergoing surgery for lumbar spinal stenosis experience unique courses of pain and disability: A group-based trajectory analysis.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Preoperative multifidus activation during movement and low back pain worsening after lumbar spinal stenosis surgery: a prospective observational study.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 · 2026Article
- 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
- Physical activity barriers and facilitators in patients awaiting spine surgery: A qualitative study.PloS one · 2026Article
- Impact of Undergoing Thoracolumbar Surgery on Patient Psychosocial Profiles.Global spine journal · 2025Article
- Article
- Identifying Weekly Trajectories of Pain Severity Using Daily Data From an mHealth Study: Cluster Analysis.JMIR mHealth and uHealth · 2024Article
- Postoperative Evaluation of Pain and Disability in Patients Undergoing Spinal Discectomy.Cureus · 2023Article
- The quality of life of 50-70 years old patients with orthopedic spinal stenosis surgery. A follow-up study (descriptive study).Caspian journal of internal medicine · 2023Article
- Association of presurgical circulating MicroRNAs with 1-year postsurgical pain reduction in spine facet osteoarthritis patients with lumbar spinal stenosis.Osteoarthritis and cartilage open · 2022Article
- Postoperative recovery patterns following discectomy surgery in patients with lumbar radiculopathy.Scientific reports · 2022Article
- Physical Predictors of Favorable Postoperative Outcomes in Patients Undergoing Laminectomy or Laminotomy for Central Lumbar Spinal Stenosis: Secondary Analysis of a Randomized Controlled Trial.Frontiers in neurology · 2022Article
- Construct validity and responsiveness of commonly used patient reported outcome instruments in decompression for lumbar spinal stenosis.Journal of clinical orthopaedics and trauma · 2021Article
- Trajectories of Disability and Low Back Pain Impact: 2-year Follow-up of the Groningen Spine Cohort.Spine · 2020Article
- Article
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Authors and funding
21 authors.
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Abstract
objectiveIdentify patient subgroups defined by trajectories of pain and disability following surgery for degenerative lumbar spinal stenosis, and investigate the construct validity of the subgroups by evaluating for meaningful differences in clinical outcomes.
methodsWe recruited patients with degenerative lumbar spinal stenosis from 13 surgical spine centers who were deemed to be surgical candidates. Study outcomes (leg and back pain numeric rating scales, modified Oswestry disability index) were measured before surgery, and after 3, 12, and 24 months. Group-based trajectory models were developed to identify trajectory subgroups for leg pain, back pain, and pain-related disability. We examined for differences in the proportion of patients achieving minimum clinically important change in pain and disability (30%) and clinical success (50% reduction in disability or Oswestry score ≤22) 12 months from surgery.
resultsData from 548 patients (mean[SD] age = 66.7[9.1] years; 46% female) were included. The models estimated 3 unique trajectories for leg pain (excellent outcome = 14.4%, good outcome = 49.5%, poor outcome = 36.1%), back pain (excellent outcome = 13.1%, good outcome = 45.0%, poor outcome = 41.9%), and disability (excellent outcome = 30.8%, fair outcome = 40.1%, poor outcome = 29.1%). The construct validity of the trajectory subgroups was confirmed by between-trajectory group differences in the proportion of patients meeting thresholds for minimum clinically important change and clinical success after 12 postoperative months (p < .001).
conclusionSubgroups of patients with degenerative lumbar spinal stenosis can be identified by their trajectories of pain and disability following surgery. Although most patients experienced important reductions in pain and disability, 29% to 42% of patients were classified as members of an outcome trajectory subgroup that experienced little to no benefit from surgery. These findings may inform appropriate expectation setting for patients and clinicians and highlight the need for better methods of treatment selection for patients with degenerative lumbar spinal stenosis.
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