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Baseline Patient Characteristics Commonly Captured Before Surgery Do Not Accurately Predict Long-Term Outcomes of Lumbar Microdiscectomy Followed by Physiotherapy

Prospective cohort study. OBJECTIVE. To develop and internally validate prognostic models based on commonly collected preoperative data for good and poor outcomes of lumbar microdiscectomy followed by physiotherapy. SUMMARY OF BACKGROUND DATA. Lumbar microdiscectomy followed by physiotherapy is a co...

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Autores principales: Willems, Stijn J., Coppieters, Michel W., Rooker, Servan, Heymans, Martijn W., Scholten-Peeters, Gwendolyne G.M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337113/
https://www.ncbi.nlm.nih.gov/pubmed/32118698
http://dx.doi.org/10.1097/BRS.0000000000003448
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author Willems, Stijn J.
Coppieters, Michel W.
Rooker, Servan
Heymans, Martijn W.
Scholten-Peeters, Gwendolyne G.M.
author_facet Willems, Stijn J.
Coppieters, Michel W.
Rooker, Servan
Heymans, Martijn W.
Scholten-Peeters, Gwendolyne G.M.
author_sort Willems, Stijn J.
collection PubMed
description Prospective cohort study. OBJECTIVE. To develop and internally validate prognostic models based on commonly collected preoperative data for good and poor outcomes of lumbar microdiscectomy followed by physiotherapy. SUMMARY OF BACKGROUND DATA. Lumbar microdiscectomy followed by physiotherapy is a common intervention for lumbar radiculopathy. Postoperatively, a considerable percentage of people continues to experience pain and disability. Prognostic models for recovery are scarce. METHODS. We included 298 patients with lumbar radiculopathy who underwent microdiscectomy followed by physiotherapy. Primary outcomes were recovery and secondary outcomes were pain and disability at 12 months follow-up. Potential prognostic factors were selected from sociodemographic and biomedical data commonly captured preoperatively. The association between baseline characteristics and outcomes was evaluated using multivariable logistic regression analyses. RESULTS. At 12 months follow-up, 75.8% of the participants met the criterion for recovery. Variables in the model for good recovery included: younger age, leg pain greater than back pain, high level of disability, and a disc herniation at another level than L3–L4. The model for poor recovery included: lower educational level, prior back surgery, and disc herniation at L3–L4. Following internal validation, the explained variance (Nagelkerke R (2)) and area under the curve for both models were poor (≤0.02 and ≤0.60, respectively). The discriminative ability of the models for disability and pain were also poor. CONCLUSION. The outcome of microdiscectomy followed by postoperative physiotherapy cannot be predicted accurately by commonly captured preoperative sociodemographic and biomedical factors. The potential value of other biomedical, personal, and external factors should be further investigated. Level of Evidence: 3
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spelling pubmed-73371132020-07-13 Baseline Patient Characteristics Commonly Captured Before Surgery Do Not Accurately Predict Long-Term Outcomes of Lumbar Microdiscectomy Followed by Physiotherapy Willems, Stijn J. Coppieters, Michel W. Rooker, Servan Heymans, Martijn W. Scholten-Peeters, Gwendolyne G.M. Spine (Phila Pa 1976) Surgery Prospective cohort study. OBJECTIVE. To develop and internally validate prognostic models based on commonly collected preoperative data for good and poor outcomes of lumbar microdiscectomy followed by physiotherapy. SUMMARY OF BACKGROUND DATA. Lumbar microdiscectomy followed by physiotherapy is a common intervention for lumbar radiculopathy. Postoperatively, a considerable percentage of people continues to experience pain and disability. Prognostic models for recovery are scarce. METHODS. We included 298 patients with lumbar radiculopathy who underwent microdiscectomy followed by physiotherapy. Primary outcomes were recovery and secondary outcomes were pain and disability at 12 months follow-up. Potential prognostic factors were selected from sociodemographic and biomedical data commonly captured preoperatively. The association between baseline characteristics and outcomes was evaluated using multivariable logistic regression analyses. RESULTS. At 12 months follow-up, 75.8% of the participants met the criterion for recovery. Variables in the model for good recovery included: younger age, leg pain greater than back pain, high level of disability, and a disc herniation at another level than L3–L4. The model for poor recovery included: lower educational level, prior back surgery, and disc herniation at L3–L4. Following internal validation, the explained variance (Nagelkerke R (2)) and area under the curve for both models were poor (≤0.02 and ≤0.60, respectively). The discriminative ability of the models for disability and pain were also poor. CONCLUSION. The outcome of microdiscectomy followed by postoperative physiotherapy cannot be predicted accurately by commonly captured preoperative sociodemographic and biomedical factors. The potential value of other biomedical, personal, and external factors should be further investigated. Level of Evidence: 3 Lippincott Williams & Wilkins 2020-07-15 2020-02-27 /pmc/articles/PMC7337113/ /pubmed/32118698 http://dx.doi.org/10.1097/BRS.0000000000003448 Text en Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Surgery
Willems, Stijn J.
Coppieters, Michel W.
Rooker, Servan
Heymans, Martijn W.
Scholten-Peeters, Gwendolyne G.M.
Baseline Patient Characteristics Commonly Captured Before Surgery Do Not Accurately Predict Long-Term Outcomes of Lumbar Microdiscectomy Followed by Physiotherapy
title Baseline Patient Characteristics Commonly Captured Before Surgery Do Not Accurately Predict Long-Term Outcomes of Lumbar Microdiscectomy Followed by Physiotherapy
title_full Baseline Patient Characteristics Commonly Captured Before Surgery Do Not Accurately Predict Long-Term Outcomes of Lumbar Microdiscectomy Followed by Physiotherapy
title_fullStr Baseline Patient Characteristics Commonly Captured Before Surgery Do Not Accurately Predict Long-Term Outcomes of Lumbar Microdiscectomy Followed by Physiotherapy
title_full_unstemmed Baseline Patient Characteristics Commonly Captured Before Surgery Do Not Accurately Predict Long-Term Outcomes of Lumbar Microdiscectomy Followed by Physiotherapy
title_short Baseline Patient Characteristics Commonly Captured Before Surgery Do Not Accurately Predict Long-Term Outcomes of Lumbar Microdiscectomy Followed by Physiotherapy
title_sort baseline patient characteristics commonly captured before surgery do not accurately predict long-term outcomes of lumbar microdiscectomy followed by physiotherapy
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337113/
https://www.ncbi.nlm.nih.gov/pubmed/32118698
http://dx.doi.org/10.1097/BRS.0000000000003448
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