Evidence map›Paper›PMID 37388594›Full record

ReviewCureus2023

Predictors of Recovery Following Lumbar Microdiscectomy for Sciatica: A Systematic Review and Meta-Analysis of Observational Studies.

Yasir Rehman, Malgorzata Bala, Nadia Rehman, Arnav Agarwal, Magdalena Koperny, Holly Crandon, Ream Abdullah, Alexandra Hull, Nima Makhdami, Savannah Grodecki and 8 more

Abstract readReview
In one paragraph

Review in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. 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

18 authors.

Yasir RehmanHealth Research Methodology, McMaster University, Hamilton, CAN.
Malgorzata BalaEpidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, POL.
Nadia RehmanHealth Research Methods, Impact and Evidence, McMaster University, Hamilton, CAN.
Arnav AgarwalMedicine, University of Toronto, Toronto, CAN.
Magdalena KopernyEpidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, POL.
Holly CrandonMichael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, CAN.
Ream AbdullahMichael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, CAN.
Alexandra HullMichael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, CAN.
Nima MakhdamiMedicine, McMaster University, Hamilton, CAN.
Savannah GrodeckiFamily Medicine, University of British Columbia, Vancouver, CAN.
Anna WrzosekInterdisciplinary Intensive Care, Jagiellonian University, Krakow, POL.
Wiktoria LesniakMedicine, Jagiellonian University Medical College, Krakow, POL.
Nathan EvaniewSurgery, University of Calgary, Calgary, CAN.
Vahid AshoorionMichael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, CAN.
Li WangMichael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, CAN.
Rachel CoubanMichael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, CAN.
Brian DrewNeurosurgery, McMaster University, Hamilton, CAN.
Jason W BusseHealth Research Methodology, McMaster University, Hamilton, CAN.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic post-surgical pain is reported by up to 40% of patients after lumbar microdiscectomy for sciatica, a complaint associated with disability and loss of productivity. We conducted a systematic review of observational studies to explore factors associated with persistent leg pain and impairments after microdiscectomy for sciatica. We searched eligible studies in MEDLINE, Embase, and CINAHL that explored, in an adjusted model, predictors of persistent leg pain, physical impairment, or failure to return to work after microdiscectomy for sciatica. When possible, we pooled estimates of association using random-effects models using the Grading of Recommendations Assessment, Development, and Evaluation approach. Moderate-certainty evidence showed that the female sex probably has a small association with persistent post-surgical leg pain (odds ratio (OR) = 1.15, 95% confidence interval (CI) = 0.63 to 2.08; absolute risk increase (ARI) = 1.8%, 95% CI = -4.7% to 11.3%), large association with failure to return to work (OR = 2.79, 95% CI = 1.27 to 6.17; ARI = 10.6%, 95% CI = 1.8% to 25.2%), and older age is probably associated with greater postoperative disability (β = 1.47 points on the 100-point Oswestry Disability Index for every 10-year increase from age (>/=18 years), 95% CI = -4.14 to 7.28). Among factors that were not possible to pool, two factors showed promise for future study, namely, legal representation and preoperative opioid use, which showed large associations with worse outcomes after surgery. The moderate-certainty evidence showed female sex is probably associated with persistent leg pain and failure to return to work and that older age is probably associated with greater post-surgical impairment after a microdiscectomy. Future research should explore the association between legal representation and preoperative opioid use with persistent pain and impairment after microdiscectomy for sciatica.

Indexed as

lumbar disc herniation surgerylumbar microdiscectomypersistent post-surgical leg painpostoperative functional impairmentprognosisreturn to worksystematic review and meta-analysis

Identifiers

PMID37388594
PMCPMC10307033

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.