ArticleBritish journal of pain2026
An observational cohort study of factors associated with patients' reports of being offered lumbar spine surgery during orthopaedic spine consultations for chronic low back pain.
Article in British journal of pain, 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
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Guidelines do not recommend lumbar spine surgery for people with chronic low back pain (CLBP). It remains unknown how these guidelines are implemented, and which factors affect the decision to offer surgery. Objectives: This study examined factors associated with patients reporting that lumbar spine surgery was recommended during specialist consultation for CLBP. Methods: Clinical, demographic and psychosocial factors were measured pre-consultation in people referred with CLBP for their first consultation with orthopaedic spine clinicians in secondary care in eight hospitals. Patients reporting leg pain, previous spinal surgery, or other specific spinal pathology were excluded. Data were analysed using binomial logistic regression. In addition, three surgeons independently rated a subsample of the MRI reports as suitable or unsuitable for lumbar spine surgery, blinded to clinical background of patients and to the consultation outcome. Results: A total of 424 patients were included in the analysis, of whom 96 reported being offered lumbar spine surgery. Patients were more likely to report being offered surgery if they were older, had a longer pain duration, had consulted more widely, and had stronger positive expectations of surgery. Pain intensity, disability, depression, and anxiety were not associated with the decision to offer surgery. The model correctly classified 80.6% of cases. In the subsample analysis based on MRI reports alone, the proportion judged as potentially suitable for lumbar spine surgery (20%) was similar to the actual consultations (22%), but concordance on who was offered surgery was poor (27%). Conclusion: In this cohort of people with CLBP without leg pain, patient perception that surgery was offered during the consultation was associated with a longer history of pain and a greater number of prior consultations. Surgical offer was patient-reported and surgeons' rationale was not captured. Subsample findings suggest that MRI findings alone should not drive surgical decision-making in CLBP.
Indexed as
Identifiers
What 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.