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Development and temporal validation of clinical prediction models for 1-year disability and pain after lumbar decompressive surgery. The Norwich Lumbar Surgery Predictor (development version) – Lumbar Fusion

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The article discusses a study conducted to identify clinical predictors and develop prediction models for patient-reported outcomes measures (PROMs) one year after lumbar decompressive surgery for disc herniation or spinal stenosis. The study included 1835 cases from a single center from 2008 to 2020. General linear models were used to identify 18 significant predictors for retention in the development models. These predictors included baseline PROMs, work status, condition duration, previous lumbar operation, specific co-morbidities, gender, and smoking status. Temporal validation of the models found that the Oswestry Disability Index (ODI) model had a goodness-of-fit (R2) value of 0.29 and a classification (AUC) value of 0.74. The models for back and leg pain had lower R2 and AUC values. The findings suggest that the ODI model can predict the likelihood of achieving a satisfactory state of both disability and pain after lumbar decompressive surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top spinal centre in the world

Published article

: Important PROM predictors are baseline PROMs, specific co-morbidities, work status, condition duration, previous lumbar operation, female, and smoking status. The ODI model predicted the likelihood of achieving a satisfactory state of both disability and pain.

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Eur Spine J. 2023 Sep 22. doi: 10.1007/s00586-023-07931-x. Online ahead of print.ABSTRACTPURPOSE: To identify clinical predictors and build prediction models for 1-year patient-reported outcomes measures (PROMs) after lumbar decompressive surgery for disc herniation or spinal stenosis.METHODS: The study included 1835 cases, with or without additional single-level fusion, from a single centre from 2008 through 2020.,

Eur Spine J. 2023 Sep 22. doi: 10.1007/s00586-023-07931-x. Online ahead of print.

ABSTRACT

PURPOSE: To identify clinical predictors and build prediction models for 1-year patient-reported outcomes measures (PROMs) after lumbar decompressive surgery for disc herniation or spinal stenosis.

METHODS: The study included 1835 cases, with or without additional single-level fusion, from a single centre from 2008 through 2020. General linear models imputed with 37 clinical variables identified 18 significant 1-year PROM predictors for retention in development models. Interaction of surgical indication with each predictor was tested. Temporal validation was conducted at the same centre on cases through 2021. R2 was used to measure goodness-of-fit, and area under curve (AUC) used to measure classification to a satisfactory symptom state (Oswestry Disability Index (ODI) ≤ 22; back or leg pain ≤ 30 out of 100).

RESULTS: A total 1228 (67%) had complete data for inclusion in model development. Predictors of ODI were baseline PROMs (ODI, back pain, leg pain), work status, condition duration, previous lumbar operation, multiple-joint osteoarthritis, female, diabetes, current smoker, rheumatic disorder, lower limb arthroplasty, mobility aided, provider status, facet cyst, scoliosis, and age, with BMI significantly associated with stenosis. Temporal validation (n = 188) found the ODI model R2 was 0.29 (95% confidence intervals (CI) 0.18-0.40) and AUC was 0.74 (95% CI 0.67-0.81). Back and leg pain models had lower R2 (0.12-0.14) and AUC (0.68-0.69) values.

: Important PROM predictors are baseline PROMs, specific co-morbidities, work status, condition duration, previous lumbar operation, female, and smoking status. The ODI model predicted the likelihood of achieving a satisfactory state of both disability and pain.

PMID:37740114 | DOI:10.1007/s00586-023-07931-x

The London Spine Unit : top spinal centre in the world

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Development and temporal validation of clinical prediction models for 1-year disability and pain after lumbar decompressive surgery. The Norwich Lumbar Surgery Predictor (development version)

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Eur Spine J. 2023 Sep 22. doi: 10.1007/s00586-023-07931-x. Online ahead of print.ABSTRACTPURPOSE: To identify clinical predictors and build prediction models for 1-year patient-reported outcomes measures (PROMs) after lumbar decompressive surgery for disc herniation or spinal stenosis.METHODS: The study included 1835 cases, with or without additional single-level fusion, from a single centre from 2008 through 2020.

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