ArticleSpine2020
Baseline Patient Characteristics Commonly Captured Before Surgery Do Not Accurately Predict Long-Term Outcomes of Lumbar Microdiscectomy Followed by Physiotherapy.
Article in Spine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.
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Who cites it
6 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Poor handling of continuous predictors in clinical prediction models using logistic regression: a systematic review.Journal of clinical epidemiology · 2023Pooled it
- Sample size requirements are not being considered in studies developing prediction models for binary outcomes: a systematic review.BMC medical research methodology · 2023Pooled it
- Predicting high health care use in patients with spinal disorder in secondary care: model development and validation.Pain reports · 2026Article
- Machine Learning Models for Predicting Disability and Pain Following Lumbar Disc Herniation Surgery.JAMA network open · 2024Article
- Review
- Quantifying the collective influence of social determinants of health using conditional and cluster modeling.PloS one · 2020Observational
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designProspective cohort study.
objectiveTo develop and internally validate prognostic models based on commonly collected preoperative data for good and poor outcomes of lumbar microdiscectomy followed by physiotherapy. SUMMARY OF BACKGROUND DATA: Lumbar microdiscectomy followed by physiotherapy is a common intervention for lumbar radiculopathy. Postoperatively, a considerable percentage of people continues to experience pain and disability. Prognostic models for recovery are scarce.
methodsWe included 298 patients with lumbar radiculopathy who underwent microdiscectomy followed by physiotherapy. Primary outcomes were recovery and secondary outcomes were pain and disability at 12 months follow-up. Potential prognostic factors were selected from sociodemographic and biomedical data commonly captured preoperatively. The association between baseline characteristics and outcomes was evaluated using multivariable logistic regression analyses.
resultsAt 12 months follow-up, 75.8% of the participants met the criterion for recovery. Variables in the model for good recovery included: younger age, leg pain greater than back pain, high level of disability, and a disc herniation at another level than L3-L4. The model for poor recovery included: lower educational level, prior back surgery, and disc herniation at L3-L4. Following internal validation, the explained variance (Nagelkerke R) and area under the curve for both models were poor (≤0.02 and ≤0.60, respectively). The discriminative ability of the models for disability and pain were also poor.
conclusionThe outcome of microdiscectomy followed by postoperative physiotherapy cannot be predicted accurately by commonly captured preoperative sociodemographic and biomedical factors. The potential value of other biomedical, personal, and external factors should be further investigated. LEVEL OF EVIDENCE: 3.
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