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Older Age and Leg Pain Are Good Predictors of Pain and Disability Outcomes in 2710 Patients Who Receive Lumbar Fusion

  • Original Article
  • Published:
HSS Journal ®

Abstract

Background

Identifying appropriate candidates for lumbar spine fusion is a challenging and controversial topic. The purpose of this study was to identify baseline characteristics related to poor/favorable outcomes at 1 year for a patient who received lumbar spine fusion.

Questions/Purposes

The aims of this study were to describe baseline characteristics of those who received lumbar surgery and to identify baseline characteristics from a spine repository that were related to poor and favorable pain and disability outcomes for patient who received lumbar fusion (with or without decompression), who were followed up for 1 full year and discriminate predictor variables that were either or in contrast to prognostic variables reported in the literature.

Methods

This study analyzed data from 2710 patients who underwent lumbar spine fusion. All patient data was part of a multicenter, multi-national spine repository. Ten relatively commonly captured data variables were used as predictors for the study. Univariate/multivariate logistic regression analyses were run against outcome variables of pain/disability.

Results

Multiple univariate findings were associated with pain/disability outcomes at 1 year including age, previous surgical history, baseline disability, baseline pain, baseline quality of life scores, and leg pain greater than back pain. Notably significant multivariate findings for both pain and disability include older age, previous surgical history, and baseline mental summary scores, disability, and pain.

Conclusion

Leg pain greater than back pain and older age may yield promising value when predicting positive outcomes. Other significant findings may yield less value since these findings are similar to those that are considered to be prognostic regardless of intervention type.

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Disclosures

Conflict of Interest

Anthony K. Frempong-Boadu, MD, and Isaac Karikari, MD, have declared that they have no conflict of interest. Robert Isaacs, MD, reports grants and personal fees from NuVasive, Inc. and personal fees from Association for Collaborative Spine Research, outside the work. Chad E. Cook, PhD, PT, is paid consultant for Hawkins Foundation of Carolinas, outside the work. Kristen Radcliff, MD, reports grants from Depuy, Medtronic, Nuvasive, and Pacira; personal fees from Depuy, Medtronic, Orthofix, Orthopedic Sciences, Inc, 4 Web Medical, NEXXT Spine, Stryker, Altus Spine, and Globus; non-financial support from LDR; and other from Association for Collaborative Spine Research, outside the work.

Human/Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed Consent

Informed consent was obtained from all patients for being included in the study.

Required Author Forms

Disclosure forms provided by the authors are available with the online version of this article.

Author information

Authors and Affiliations

  1. Department of Orthopedics, Duke University, 2200 W. Main St. Ste. B230, Durham, NC, USA

    Chad E. Cook PhD, PT

  2. Department of Neurosurgery, Division of Spinal Surgery, New York University - Langone Medical Center, 530 1st Avenue, Skirball Suite 8R, New York, NY, 10016, USA

    Anthony K. Frempong-Boadu MD

  3. Department of Orthopedic Surgery, Rothman Institute, 2500 English Creek Avenue, Egg Harbor, NJ, 08234, USA

    Kristen Radcliff MD

  4. Division of Neurosurgery, Duke University Medical Center, 200 Trent Drive #1l, Durham, NC, 27710, USA

    Isaac Karikari MD & Robert Isaacs MD

Authors
  1. Chad E. Cook PhD, PT
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  2. Anthony K. Frempong-Boadu MD
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Corresponding author

Correspondence to Chad E. Cook PhD, PT.

Additional information

Level of Evidence: Level II: Retrospective Prognostic Study.

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Cook, C.E., Frempong-Boadu, A.K., Radcliff, K. et al. Older Age and Leg Pain Are Good Predictors of Pain and Disability Outcomes in 2710 Patients Who Receive Lumbar Fusion. HSS Jrnl 11, 209–215 (2015). https://doi.org/10.1007/s11420-015-9456-6

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  • DOI: https://doi.org/10.1007/s11420-015-9456-6

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