Journal article
Predictors of clinical outcome following lumbar disc surgery: The value of historical, physical examination, and muscle function variables
European Spine Journal, Vol.25(1), pp.310-317
2015
Abstract
Purpose
Explore the relationships between preoperative findings and clinical outcome following lumbar disc surgery, and investigate the prognostic value of physical examination findings after accounting for information acquired from the clinical history.
Methods
We recruited 55 adult patients scheduled for first time, single-level lumbar discectomy. Participants underwent a standardized preoperative evaluation including real-time ultrasound imaging assessment of lumbar multifidus function, and an 8-week postoperative rehabilitation programme. Clinical outcome was defined by change in disability, and leg and low back pain (LBP) intensity at 10 weeks. Linear regression models were used to identify univariate and multivariate predictors of outcome.
Results
Univariate predictors of better outcome varied depending on the outcome measure. Clinical history predictors included a greater proportion of leg pain to LBP, pain medication use, greater time to surgery, and no history of previous physical or injection therapy. Physical examination predictors were a positive straight or cross straight leg raise test, diminished lower extremity strength, sensation or reflexes, and the presence of postural abnormality or pain peripheralization. Preoperative pain peripheralization remained a significant predictor of improved disability (p = 0.04) and LBP (p = 0.02) after accounting for information from the clinical history. Preoperative lumbar multifidus function was not associated with clinical outcome.
Conclusions
Information gleaned from the clinical history and physical examination helps to identify patients more likely to succeed with lumbar disc surgery. While this study helps to inform clinical practice, additional research confirming these results is required prior to confident clinical implementation.
Details
- Title
- Predictors of clinical outcome following lumbar disc surgery: The value of historical, physical examination, and muscle function variables
- Authors/Creators
- J.J. Hebert (Author/Creator) - Murdoch UniversityJ.M. Fritz (Author/Creator) - Intermountain HealthcareS.L. Koppenhaver (Author/Creator) - Murdoch UniversityA. Thackeray (Author/Creator) - University of UtahP. Kjaer (Author/Creator) - University of Southern Denmark
- Publication Details
- European Spine Journal, Vol.25(1), pp.310-317
- Publisher
- Springer-Verlag
- Identifiers
- 991005542787507891
- Murdoch Affiliation
- School of Psychology and Exercise Science
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
- Domestic collaboration
- International collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.129 Back pain
- 1.129.175 Spinal Disorders
- Web Of Science research areas
- Clinical Neurology
- Orthopedics
- ESI research areas
- Clinical Medicine