TY - JOUR
T1 - Do patients with back pain-dominant symptoms improve after lumbar surgery for radiculopathy or claudication?
AU - Divi, Srikanth N.
AU - Woods, Barrett I.
AU - Goyal, Dhruv K.C.
AU - Galetta, Matthew S.
AU - Nicholson, Kristen J.
AU - Dimatteo, Andrew L.
AU - Lam, Meghan E.
AU - Qureshi, Mahir A.
AU - Anderson, D. Greg
AU - Kurd, Mark F.
AU - Rihn, Jeffrey A.
AU - Kaye, Ian D.
AU - Kepler, Christopher K.
AU - Hilibrand, Alan S.
AU - Vaccaro, Alexander R.
AU - Radcliff, Kristen E.
AU - Schroeder, Gregory D.
N1 - Publisher Copyright:
© 2021 ISASS. All rights reserved.
PY - 2021/8/1
Y1 - 2021/8/1
N2 - Background: Currently, few studies have examined whether patients with back or leg pain-predominant symptoms fare better clinically after lumbar spine surgery; therefore, the purpose of this study was to determine whether patients with back pain-dominant symptoms improved to a similar degree as patients with mixed or leg pain-dominant symptoms after lumbar surgery. Methods: A retrospective cohort study was conducted at a single academic center, in which patients were stratified into three groups: (1) back pain-dominant group (B) (visual analog score [VAS] back - VAS leg ≥1.0 point), (2) neutral group (N) (VAS back - VAS leg, 1.0 point), or (3) leg pain-dominant group (L) (VAS leg - VAS back ≥ 1.0 point), using a VAS threshold difference of 1.0 point. As a secondary analysis, the VAS leg-to-back pain (LBR) ratio was used to further stratify patients: (1) nonleg pain-dominant (NLPD) group (LBR ≤ 1.0) or (2) leg pain-dominant (LPD) group (LBR. 1.0). Patient outcomes, including physical component score of the short form-12 survey (PCS-12), mental component score of the short form-12 survey (MCS-12), and Oswestry Disability Index (ODI), were identified and compared between groups using univariate and multivariate analysis. Results: There were no significant differences in preoperative, postoperative, or delta scores for PCS-12 or ODI scores between groups. In patients undergoing decompression surgery, those with back pain-dominant or mixed symptoms (B, N, or NLPD groups) did not improve with respect to MCS-12 scores after surgery (P..05), and those with leg pain-dominant symptoms (LPD group) had greater delta MCS-12 scores (P =.046) and greater recovery rates (P =.035). Multiple linear regression did not find LPD to be an independent predictor of PCS-12 or ODI scores. Conclusion: Patients undergoing lumbar decompression surgery and leg pain-dominant symptoms noted a greater improvement in MCS-12 scores; however, there were no differences in PCS-12 or ODI scores.
AB - Background: Currently, few studies have examined whether patients with back or leg pain-predominant symptoms fare better clinically after lumbar spine surgery; therefore, the purpose of this study was to determine whether patients with back pain-dominant symptoms improved to a similar degree as patients with mixed or leg pain-dominant symptoms after lumbar surgery. Methods: A retrospective cohort study was conducted at a single academic center, in which patients were stratified into three groups: (1) back pain-dominant group (B) (visual analog score [VAS] back - VAS leg ≥1.0 point), (2) neutral group (N) (VAS back - VAS leg, 1.0 point), or (3) leg pain-dominant group (L) (VAS leg - VAS back ≥ 1.0 point), using a VAS threshold difference of 1.0 point. As a secondary analysis, the VAS leg-to-back pain (LBR) ratio was used to further stratify patients: (1) nonleg pain-dominant (NLPD) group (LBR ≤ 1.0) or (2) leg pain-dominant (LPD) group (LBR. 1.0). Patient outcomes, including physical component score of the short form-12 survey (PCS-12), mental component score of the short form-12 survey (MCS-12), and Oswestry Disability Index (ODI), were identified and compared between groups using univariate and multivariate analysis. Results: There were no significant differences in preoperative, postoperative, or delta scores for PCS-12 or ODI scores between groups. In patients undergoing decompression surgery, those with back pain-dominant or mixed symptoms (B, N, or NLPD groups) did not improve with respect to MCS-12 scores after surgery (P..05), and those with leg pain-dominant symptoms (LPD group) had greater delta MCS-12 scores (P =.046) and greater recovery rates (P =.035). Multiple linear regression did not find LPD to be an independent predictor of PCS-12 or ODI scores. Conclusion: Patients undergoing lumbar decompression surgery and leg pain-dominant symptoms noted a greater improvement in MCS-12 scores; however, there were no differences in PCS-12 or ODI scores.
KW - Lumbar surgery
KW - Mental component score of the short form-12 (MCS-12)
KW - Oswestry Disability Index (ODI)
KW - Patient-reported outcome measurements (PROMs)
KW - Physical component score of the short form-12 (PCS-12)
KW - VAS pain dominance
KW - Visual analog scale back pain (VAS back)
KW - Visual analog scale leg pain (VAS leg)
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U2 - 10.14444/8100
DO - 10.14444/8100
M3 - Article
C2 - 34266928
AN - SCOPUS:85113994295
SN - 2211-4599
VL - 15
SP - 780
EP - 787
JO - International Journal of Spine Surgery
JF - International Journal of Spine Surgery
IS - 4
ER -