Evidence map›Paper›PMID 37237240›Full record

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

Predictors of poor outcome following lumbar spinal fusion surgery: a prospective observational study to derive two clinical prediction rules using British Spine Registry data.

Alison B Rushton, Feroz Jadhakhan, Martin L Verra, Andrew Emms, Nicola R Heneghan, Deborah Falla, Michael Reddington, Ashley A Cole, Paul C Willems, Lorin Benneker and 4 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study 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 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 24% of its field
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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. 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

14 authors at 10 institutions in 5 countries.

Alison B RushtonSchool of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada. arushto3@uwo.ca.ORCID 0000-0001-8114-7669
Feroz JadhakhanCentre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
Martin L VerraDepartment of Physiotherapy, Berne University Hospital, Bern, Switzerland.
Andrew EmmsDepartment of Physiotherapy, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.
Nicola R HeneghanCentre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
Deborah FallaCentre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
Michael ReddingtonPhysiotherapy Department, Sheffield Teaching Hospitals NHS Trust, Northern General Hospital, Sheffield, UK.
Ashley A ColeDepartment of Orthopaedics and Trauma, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Paul C WillemsMaastricht University Medical Centre, Maastricht, The Netherlands.
Lorin BennekerDepartment of Orthopaedic Surgery Inselspital, University of Bern, Bern, Switzerland.
David SelveyAmplitude Clinical, Host of the British Spine Registry, Droitwich, UK.
Michael HuttonPrincess Elizabeth Orthopaedic Centre (PEOC), Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.
Martijn W HeymansDepartment of Epidemiology and Biostatistics, Amsterdam University Medical Center, Amsterdam, The Netherlands.
J Bart StaalRadboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands.
University of Birmingham · GBMaastricht University Medical Centre · NLNorthern General Hospital · GBRadboud University Nijmegen · NLRoyal Devon & Exeter NHS Foundation Trust · GBRoyal Orthopaedic Hospital · GBSheffield Teaching Hospitals NHS Foundation Trust · GBUniversity Hospital of Bern · CHUniversity of Bern · CHWestern University · CA

Funding

Research Stimulation Funding, University of Birmingham, UK Funding for modification of the British Spine Registry
6 · The paper itself

Abstract

purposeLumbar spinal fusion surgery (LSFS) is common for lumbar degenerative disorders. The objective was to develop clinical prediction rules to identify which patients are likely to have a favourable outcome to inform decisions regarding surgery and rehabilitation.

methodsA prospective observational study recruited 600 (derivation) and 600 (internal validation) consecutive adult patients undergoing LSFS for degenerative lumbar disorder through the British Spine Registry. Definition of good outcome (6 weeks, 12 months) was reduction in pain intensity (Numerical Rating Scale, 0-10) and disability (Oswestry Disability Index, ODI 0-50) > 1.7 and 14.3, respectively. Linear and logistic regression models were fitted and regression coefficients, Odds ratios and 95% CIs reported.

resultsLower BMI, higher ODI and higher leg pain pre-operatively were predictive of good disability outcome, higher back pain was predictive of good back pain outcome, and no previous surgery and higher leg pain were predictive of good leg pain outcome; all at 6 weeks. Working and higher leg pain were predictive of good ODI and leg pain outcomes, higher back pain was predictive of good back pain outcome, and higher leg pain was predictive of good leg pain outcome at 12 months. Model performance demonstrated reasonable to good calibration and adequate/very good discrimination.

conclusionsBMI, ODI, leg and back pain and previous surgery are important considerations pre-operatively to inform decisions for surgery. Pre-operative leg and back pain and work status are important considerations to inform decisions for management following surgery. Findings may inform clinical decision making regarding LSFS and associated rehabilitation.

Indexed as

Spinal FusionAdultBack PainClinical Decision RulesHumansLumbar VertebraeRoutinely Collected Health DataTreatment OutcomeClinical prediction rulesLumbar spinal fusion surgeryProspective observational studyRehabilitationSurgery

Identifiers

PMID37237240
OpenAlexW4378373815

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.