ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Central sensitization-related symptoms in patients undergoing lumbar spine surgery: development and internal validation of a clinical prediction rule for first-stage screening.
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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCentral sensitization (CS)-related symptoms are associated with poor outcomes after lumbar spine surgery, but universal screening may be inefficient when only a minority of patients are affected. This study aimed to develop and internally validate a clinical prediction rule (CPR) to screen for elevated CS-related symptom burden (Central Sensitization Inventory-9 [CSI-9] ≥ 20) using routinely collected clinical variables.
methodsIn this cross-sectional diagnostic prediction model study, 674 consecutive patients scheduled for lumbar spine surgery were included; 97 (14.4%) had CSI-9 scores ≥ 20. Seven candidate predictors were evaluated using logistic regression with backward elimination. A 3-item CPR was derived by dichotomizing retained predictors at Youden-optimal cutpoints. Internal validation used 1,000 bootstrap resamples.
resultsThree predictors were retained: age ≤ 60 years, ≥ 5 pain sites, and sleep disturbance (Oswestry Disability Index sleep item ≥ 1). The CPR showed discrimination comparable to the full model (AUC, 0.730; DeLong P = 0.872). At the optimal cutoff (≥ 2 points), sensitivity was 73.2%, specificity 65.0%, and negative predictive value 93.5%. Low-risk patients (score 0-1; 59.5% of the cohort) had an event rate of 6.5%. Decision curve analysis confirmed positive net benefit across threshold probabilities of 5-40%.
conclusionA simple 3-item CPR demonstrated moderate discrimination with high negative predictive value for elevated CS-related symptom burden before lumbar spine surgery. The rule may serve as a practical first-stage screen to guide selective CSI-9 administration.
Indexed as
Identifiers
42289020What OpenQuestion holds
Registered trials
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.