Evidence map›Paper›PMID 36877367›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2023

Multi-domain biopsychosocial postoperative recovery trajectories associate with patient outcomes following lumbar fusion.

Ryan T Halvorson, Abel Torres-Espin, Matthew Callahan, Bobby Tay, Conor O'Neill, Sigurd Berven, Jeffrey C Lotz, Jeannie F Bailey

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In one paragraph

Article in 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, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Observational
  3. Article
  4. Review
  5. Personalized Approaches to Spine Surgery.International journal of spine surgery · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ryan T HalvorsonDepartment of Orthopedic Surgery, University of California, San Francisco, USA.
Abel Torres-EspinDepartment of Neurological Surgery, University of California, San Francisco, USA.
Matthew CallahanDepartment of Orthopedic Surgery, University of California, San Francisco, USA.
Bobby TayDepartment of Orthopedic Surgery, University of California, San Francisco, USA.
Conor O'NeillDepartment of Orthopedic Surgery, University of California, San Francisco, USA.
Sigurd BervenDepartment of Orthopedic Surgery, University of California, San Francisco, USA.
Jeffrey C LotzDepartment of Orthopedic Surgery, University of California, San Francisco, USA.
Jeannie F BaileyDepartment of Orthopedic Surgery, University of California, San Francisco, USA. Jeannie.Bailey@ucsf.edu.ORCID 0000-0003-4618-7512

Funding

UCSF Core Center for Patient-centric Mechanistic Phenotyping in Chronic Low Back PainU19AR076737 · NIAMS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LOTZ, JEFFREY C. · 2019 to 2023
$34.1M
NIAMS NIH HHS U19 AR076737
6 · The paper itself

Abstract

purposeThe purpose of this study is to describe and assess the impact of multi-domain biopsychosocial (BPS) recovery on outcomes following lumbar spine fusion. We hypothesized that discrete patterns of BPS recovery (e.g., clusters) would be identified, and then associated with postoperative outcomes and preoperative patient data.

methodsPatient-reported outcomes for pain, disability, depression, anxiety, fatigue, and social roles were collected at multiple timepoints for patients undergoing lumbar fusion between baseline and one year. Multivariable latent class mixed models assessed composite recovery as a function of (1) pain, (2) pain and disability, and (3) pain, disability, and additional BPS factors. Patients were assigned to clusters based on their composite recovery trajectories over time.

resultsUsing all BPS outcomes from 510 patients undergoing lumbar fusion, three multi-domain postoperative recovery clusters were identified: Gradual BPS Responders (11%), Rapid BPS Responders (36%), and Rebound Responders (53%). Modeling recovery from pain alone or pain and disability alone failed to generate meaningful or distinct recovery clusters. BPS recovery clusters were associated with number of levels fused and preoperative opioid use. Postoperative opioid use (p < 0.01) and hospital length of stay (p < 0.01) were associated with BPS recovery clusters even after adjusting for confounding factors.

conclusionThis study describes distinct clusters of recovery following lumbar spine fusion derived from multiple BPS factors, which are related to patient-specific preoperative factors and postoperative outcomes. Understanding postoperative recovery trajectories across multiple health domains will advance our understanding of how BPS factors interact with surgical outcomes and could inform personalized care plans.

Indexed as

Lumbar VertebraeSpinal FusionAnalgesics, OpioidHumansLumbosacral RegionPainRetrospective StudiesTreatment OutcomeAnalgesics, OpioidBiopsychosocialLumbar spinePatient outcomesRecovery trajectoriesSpinal fusion

Identifiers

PMID36877367
PMCPMC12445349

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.