Evidence map›Paper›PMID 42170383›Full record

ArticleBrain & spine2026

The first week matters: App-based PROM trajectories and follow-up retention after endoscopic lumbar surgery.

Phil Bohlen, Jannik Leyendecker, Cathryn Payne, Paula Krause, Eliana Bieler, Jan Bredow, Peer Eysel, Albert Telfeian, Peter Derman, Osama Kashlan and 15 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Brain & spine, 2026. 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
–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

2 citing papers in PubMed.

  1. Review
  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

25 authors.

Phil BohlenDepartment of Neurological Surgery, University of Washington, Seattle, WA, USA.
Jannik LeyendeckerFaculty of Medicine and University Hospital Cologne, University of Cologne, Department of Orthopedics and Trauma Surgery, Cologne, Germany.
Cathryn PayneDepartment of Neurological Surgery, University of Washington, Seattle, WA, USA.
Paula KrauseDepartment of Orthopedics and Trauma Surgery, Krankenhaus Porz am Rhein, University of Cologne, Germany.
Eliana BielerDepartment of Neurological Surgery, University of Washington, Seattle, WA, USA.
Jan BredowFaculty of Medicine and University Hospital Cologne, University of Cologne, Department of Orthopedics and Trauma Surgery, Cologne, Germany.
Peer EyselFaculty of Medicine and University Hospital Cologne, University of Cologne, Department of Orthopedics and Trauma Surgery, Cologne, Germany.
Albert TelfeianDepartment of Neurosurgery, Warren Alpert Medical School, Brown University, Providence, RI, USA.
Peter DermanTexas Back Institute, Plano, TX, USA.
Osama KashlanDepartment of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
Sanjay KonakondlaDepartment of Neurosurgery, Geisinger Neuroscience Institute, Danville, PA, USA.
John OgunladeDepartment of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
Saqib HasanGolden State Orthopedics & Spine, California, USA.
Meng HuangHouston Methodist Department of Neurosurgery, Texas, USA.
Mark MahanUniversity of Utah NeuroSpine, Utah, USA.
Imad KhanDepartment of Neurological Surgery, University of Washington, Seattle, WA, USA.
Raymond J GardockiDepartment of Orthopaedic Surgery, Vanderbilt Health, Tennesse, USA.
Mark LambrechtsDepartment of Orthopaedic Surgery, Washington University in St. Louis, Missouri, USA.
Anubhav AminDepartment of Neurological Surgery, University of Washington, Seattle, WA, USA.
David HuieDuke Spine Division, Duke University School of Medicine, North Carolina, USA.
Dan HafezDepartment of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
Galal ElsayedDepartment of Neurological Surgery, Weill Cornell Medicine, New York, USA.
Gregory BasilDepartment of Neurosurgery, University of Miami, USA.
Christoph P HofstetterDepartment of Neurological Surgery, University of Washington, Seattle, WA, USA.
Endoscopic Spine Research Group (ESRG)

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Full-endoscopic spine surgery (FESS) is increasingly utilized for the treatment of degenerative lumbar spinal disorders, with the aim of minimizing tissue disruption and facilitating recovery. Concurrently, postoperative follow-up is shifting toward digital platforms, enabling high-frequency collection of patient-reported outcome measures (PROMs). The characteristics of postoperative recovery trajectories and the determinants of long-term follow-up adherence in this setting remain incompletely defined. Research question: Do postoperative PROM trajectories and follow-up retention differ between full-endoscopic lumbar discectomy and decompression, and does early postoperative engagement predict long-term follow-up compliance? Material and methods: This prospective multicenter cohort study included adult patients undergoing lumbar full-endoscopic discectomy or decompression for degenerative pathology between 2018 and 2025. Postoperative PROMs were collected using a smartphone-based application on a daily basis during the first postoperative week and at predefined intervals up to six months. Outcomes included visual analog scale (VAS) scores for back and leg pain and the Oswestry Disability Index (ODI). Longitudinal PROM trajectories were analyzed, and follow-up retention was assessed using Kaplan-Meier analysis and Cox proportional hazards regression in a baseline-engaged cohort. Early postoperative PROM adherence was evaluated as a predictor of long-term retention. Results: A total of 478 patients were analyzed (279 discectomy, 199 decompression). Both cohorts demonstrated significant and sustained reductions in back and leg pain beginning on postoperative day one and persisting through six months (all p < 0.001). Functional recovery, as measured by ODI, followed a delayed course and exhibited a transient early postoperative increase in the decompression cohort. Six-month complete PROM datasets were available in 31.6% of discectomy patients and 48.4% of decompression patients. Follow-up retention differed significantly between procedures, with decompression associated with a lower hazard of dropout (adjusted HR 0.60, 95% CI 0.50-0.72). Higher PROM completion during the first postoperative week was independently associated with long-term follow-up compliance. Discussion: High-frequency app-based PROM assessment allows detailed evaluation of early and mid-term recovery following FESS. However, long-term outcome interpretation is constrained by follow-up attrition, which varies by procedure type. Conclusion: Early postoperative engagement appears to be a key determinant of durable follow-up and represents a potential target for improving longitudinal outcome assessment.

Indexed as

Degenerative spine diseaseDigital follow-upEndoscopic spine surgeryPatient-reported outcome measuresPostoperative recovery

Identifiers

PMID42170383
PMCPMC13188115

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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.