A prognostic model for failure and worsening after lumbar microdiscectomy: a multicenter study from the Norwegian Registry for Spine Surgery.
Lumbar disc surgery
Microdiscectomy
ODI
Outcome
PROM
Quality
Journal
Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000
Informations de publication
Date de publication:
09 2021
09 2021
Historique:
received:
10
12
2020
accepted:
19
04
2021
pubmed:
11
7
2021
medline:
25
11
2021
entrez:
10
7
2021
Statut:
ppublish
Résumé
To develop a prognostic model for failure and worsening 1 year after surgery for lumbar disc herniation. This multicenter cohort study included 11,081 patients operated with lumbar microdiscectomy, registered at the Norwegian Registry for Spine Surgery. Follow-up was 1 year. Uni- and multivariate logistic regression analyses were used to assess potential prognostic factors for previously defined cut-offs for failure and worsening on the Oswestry Disability Index scores 12 months after surgery. Since the cut-offs for failure and worsening are different for patients with low, moderate, and high baseline ODI scores, the multivariate analyses were run separately for these subgroups. Data were split into a training (70%) and a validation set (30%). The model was developed in the training set and tested in the validation set. A prediction (%) of an outcome was calculated for each patient in a risk matrix. The prognostic model produced six risk matrices based on three baseline ODI ranges (low, medium, and high) and two outcomes (failure and worsening), each containing 7 to 11 prognostic factors. Model discrimination and calibration were acceptable. The estimated preoperative probabilities ranged from 3 to 94% for failure and from 1 to 72% for worsening in our validation cohort. We developed a prognostic model for failure and worsening 12 months after surgery for lumbar disc herniation. The model showed acceptable calibration and discrimination, and could be useful in assisting physicians and patients in clinical decision-making process prior to surgery.
Identifiants
pubmed: 34245366
doi: 10.1007/s00701-021-04859-3
pii: 10.1007/s00701-021-04859-3
pmc: PMC8357664
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2567-2580Informations de copyright
© 2021. The Author(s).
Références
Ablin JN, Berman M, Aloush V, Regev G, Salame K, Buskila D, Lidar Z (2016) Effect of fibromyalgia symptoms on outcome of spinal surgery. Pain Med pnw232
Atlas SJ, Keller RB, Wu YA, Deyo RA, Singer DE (2005) Long-term outcomes of surgical and nonsurgical management of lumbar spinal stenosis: 8 to 10 year results from the maine lumbar spine study. Spine (Phila Pa 1976) 30(1528–1159 (Electronic)):936–943
doi: 10.1097/01.brs.0000158953.57966.c0
Bailey CS, Rasoulinejad P, Taylor D et al (2020) Surgery versus conservative care for persistent sciatica lasting 4 to 12 months. N Engl J Med 382(12):1093–1102
doi: 10.1056/NEJMoa1912658
Baker DJ PPB and FCT (1990) The Oswestry Disability Index revisited: its reliability, repeatability and validity, and a comparison with the St Thomas’s Disability Index. Back Pain New approaches to Rehabil Educ 174–186
Clement RC, Welander A, Stowell C et al (2015) A proposed set of metrics for standardized outcome reporting in the management of low back pain. Acta Orthop 86(5):523–533
doi: 10.3109/17453674.2015.1036696
Copay AG, Glassman SD, Subach BR, Berven S, Schuler TC, Carreon LY (2008) Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales. Spine J 8(1529–9430 (Print)):968–974
doi: 10.1016/j.spinee.2007.11.006
Dahl FA, Grotle M, Šaltyte Benth J, Natvig B (2008) Data splitting as a countermeasure against hypothesis fishing: with a case study of predictors for low back pain. Eur J Epidemiol 23(4):237–242
doi: 10.1007/s10654-008-9230-x
Deyo RA, Mirza SK (2009) The case for restraint in spinal surgery: does quality management have a role to play? Eur Spine J 18(1432–0932 (Electronic)):331–337
doi: 10.1007/s00586-009-0908-x
Deyo RA, Mirza SK (2016) Herniated lumbar intervertebral disk. N Engl J Med 374(18):1763–1772
doi: 10.1056/NEJMcp1512658
Fjeld O, Grotle M, Siewers V, Pedersen LM, Nilsen KB, Zwart J (2017) Prognostic factors for persistent leg-pain. https://doi.org/10.1097/BRS.0000000000001773
Gliklich RE, Dreyer NA (2014) Registries for evaluating patient outcomes, 3rd edition. p Chapter 3, section 10
Haugen AJ, Brox JI, Grovle L, Keller A, Natvig B, Soldal D, Grotle M (2012) Prognostic factors for non-success in patients with sciatica and disc herniation. BMC Musculoskelet Disord 13:183. https://doi.org/10.1186/1471-2474-13-183
doi: 10.1186/1471-2474-13-183
pubmed: 22999108
pmcid: 3495213
Hojmark K, Stottrup C, Carreon L, Andersen MO (2015) Patient-reported outcome measures unbiased by loss of follow-up. Single-center study based on DaneSpine, the Danish spine surgery registry. Eur spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 282–286
James SL, Abate D, Abate KH et al (2018) Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 392(10159):1789–1858
doi: 10.1016/S0140-6736(18)32279-7
Järvimäki V, Kautiainen H, Haanpää M, Koponen H (2016) Depressive symptoms are associated with poor outcome for lumbar spine surgery 12:13–17
Khor S, Lavallee D, Cizik AM et al (2018) Development and validation of a prediction model for pain and functional outcomes after lumbar spine surgery. JAMA Surg 153(7):634–642
doi: 10.1001/jamasurg.2018.0072
Kleinstueck FS, Fekete T, Jeszenszky D, Mannion AF, Grob D, Lattig F, Mutter U, Porchet F (2011) The outcome of decompression surgery for lumbar herniated disc is influenced by the level of concomitant preoperative low back pain. Eur Spine J 20(7):1166–1173
doi: 10.1007/s00586-010-1670-9
Koerner JD, Glaser J, Radcliff K (2015) Which variables are associated with patient-reported outcomes after discectomy? Review of SPORT disc herniation studies. Clin Orthop Relat Res 473(6):2000–2006
doi: 10.1007/s11999-014-3671-1
Konstantinou K, Dunn KM (2008) Sciatica: review of epidemiological studies and prevalence estimates. Spine (Phila Pa 1976) 33(22):2464–2472
doi: 10.1097/BRS.0b013e318183a4a2
Lurie JD, Tosteson TD, Tosteson ANA, Zhao W, Morgan TS, Abdu WA, Herkowitz H, Weinstein JN (2014) Surgical versus nonoperative treatment for lumbar disc herniation. Spine (Phila Pa 1976) 39(1):3–16
doi: 10.1097/BRS.0000000000000088
Madsbu MA, Salvesen Ø, Carlsen SM, Westin S, Onarheim K, Nygaard ØP, Solberg TK, Gulati S (2020) Surgery for herniated lumbar disc in private vs public hospitals: a pragmatic comparative effectiveness study. Acta Neurochir (Wien) 162(3):703–711
doi: 10.1007/s00701-019-04195-7
Mannion AF, Elfering A (2006) Predictors of surgical outcome and their assessment. Eur Spine J 15(Suppl 1(0940–6719 (Print))):S93-108
doi: 10.1007/s00586-005-1045-9
Mannion AF, Impellizzeri FM, Leunig M, Jeszenszy D, Becker HJ, Haschtmann D, Preiss S, Fekete TF (2018) EUROSPINE 2017 FULL PAPER AWARD: time to remove our rose-tinted spectacles: a candid appraisal of the relative success of surgery in over 4500 patients with degenerative disorders of the lumbar spine, hip or knee. Eur Spine J 27(4):778–788
doi: 10.1007/s00586-018-5469-4
McGirt MJ, Sivaganesan A, Asher AL, Devin CJ (2015) Prediction model for outcome after low-back surgery: individualized likelihood of complication, hospital readmission, return to work, and 12-month improvement in functional disability. Neurosurg Focus 39(6):1–10
doi: 10.3171/2015.8.FOCUS15338
McGirt MJ, Bydon M, Archer KR et al (2017) An analysis from the Quality Outcomes Database, Part 1. Disability, quality of life, and pain outcomes following lumbar spine surgery: Predicting likely individual patient outcomes for shared decision-making. J Neurosurg Spine 27(4):357–369
doi: 10.3171/2016.11.SPINE16526
Moons KGM, Royston P, Vergouwe Y, Grobbee DE, Altman DG (2009) Prognosis and prognostic research: what, why, and how? BMJ 338(7706):1317–1320
Nerland US, Jakola AS, Solheim O et al (2015) Minimally invasive decompression versus open laminectomy for central stenosis of the lumbar spine: pragmatic comparative effectiveness study. BMJ 350(apr01 1):h1603–h1603
doi: 10.1136/bmj.h1603
Peul WC, van Houwelingen HC, van den Hout WB, Brand R, Eekhof JAH, Tans JTJ, Thomeer RTWM, Koes BW, Leiden-The Hague Spine Intervention Prognostic Study Group (2007) Surgery versus prolonged conservative treatment for sciatica. N Engl J Med 356(22):2245–2256
doi: 10.1056/NEJMoa064039
Pieber K, Salomon N, Inschlag S, Amtmann G, Resch KL, Ebenbichler G (2016) Predictors of an unfavorable outcome 1.5 and 12 years after a first, uncomplicated lumbar disc surgery. Eur Spine J 25(11):3520–3527
doi: 10.1007/s00586-016-4700-4
Riley RD, Hayden JA, Steyerberg EW, Moons KGM, Abrams K, Briggs A, Schroter S, Altman DG, Kyzas PA (2013) Prognosis Research Strategy (PROGRESS) 2: Prognostic Factor Research. https://doi.org/10.1136/bmj.e5595
Royston P, Moons KGM, Altman DG, Vergouwe Y (2009) Prognosis and prognostic research: Developing a prognostic model. BMJ 338:b604
doi: 10.1136/bmj.b604
Solberg TK, Nygaard OP, Sjaavik K, Hofoss D, Ingebrigtsen T (2005) The risk of “getting worse” after lumbar microdiscectomy. Eur Spine J 14((0940–6719 (Print))):49–54
doi: 10.1007/s00586-004-0721-5
Solberg TK, Sorlie A, Sjaavik K, Nygaard OP, Ingebrigtsen T (2011) Would loss to follow-up bias the outcome evaluation of patients operated for degenerative disorders of the lumbar spine?: a study of responding and non-responding cohort participants from a clinical spine surgery registry. Acta Orthop 82(1):56–63
doi: 10.3109/17453674.2010.548024
Steyerberg E, Moons KGM, van der Windt D, Hayden J, Perel P, Schroter S, Riley R, Hemingway H, Altman RB (2013) Prognosis research strategy PROGRESS series 3: prognostic model research. PLoS Med 10(2):e1001381
doi: 10.1371/journal.pmed.1001381
Taylor RS, Taylor RJ (2012) The economic impact of failed back surgery syndrome. Br J Pain 6(4):174–181
doi: 10.1177/2049463712470887
Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, Egger M, Initiative STROBE (2007) Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Epidemiology 18(6):805–835
doi: 10.1097/EDE.0b013e3181577511
Weber H (1983) Lumbar disc herniation. A controlled, prospective study with ten years of observation. Spine (Phila Pa 1976) 8(0362–2436):131–140
doi: 10.1097/00007632-198303000-00003
Werner DAT, Grotle M, Gulati S, Austevoll IM, Lønne G, Nygaard Øystein P, Solberg TK (2017) Criteria for failure and worsening after surgery for lumbar disc herniation: a multicenter observational study based on data from the Norwegian Registry for Spine Surgery. Eur Spine J. https://doi.org/10.1007/s00586-017-5185-5
Werner DAT, Grotle M, Gulati S, Austevoll IM, Madsbu MA, Lønne G, Solberg TK (2019) Can a successful outcome after surgery for lumbar disc herniation be defined by the Oswestry Disability Index raw score? Glob Spine J 219256821985148