Do Patients with Back Pain-Dominant Symptoms Improve After Lumbar Surgery for Radiculopathy or Claudication?

Authors

• Srikanth N Divi
• Barrett I Woods
• Dhruv K C Goyal
• Matthew S Galetta
• Kristen J Nicholson
• Andrew L Dimatteo
• Meghan E Lam
• Mahir A Qureshi
• D Greg Anderson
• Mark F Kurd
• Jeffrey A Rihn
• Ian D Kaye
• Christopher K Kepler
• Alan S Hilibrand
• Alexander R Vaccaro
• Kristen E Radcliff
• Gregory D Schroeder

Publication/Presentation Date

8-1-2021

Abstract

BACKGROUND: Currently, few studies have examined whether patients with back or leg pain-predominant symptoms fare better clinically after lumbar spine surgery; therefore, the purpose of this study was to determine whether patients with back pain-dominant symptoms improved to a similar degree as patients with mixed or leg pain-dominant symptoms after lumbar surgery.

METHODS: A retrospective cohort study was conducted at a single academic center, in which patients were stratified into three groups: (1) back pain-dominant group (B) (visual analog score [VAS] back - VAS leg ≥ 1.0 point), (2) neutral group (N) (VAS back - VAS leg < 1.0 point), or (3) leg pain-dominant group (L) (VAS leg - VAS back ≥ 1.0 point), using a VAS threshold difference of 1.0 point. As a secondary analysis, the VAS leg-to-back pain (LBR) ratio was used to further stratify patients: (1) nonleg pain-dominant (NLPD) group (LBR ≤ 1.0) or (2) leg pain-dominant (LPD) group (LBR > 1.0). Patient outcomes, including physical component score of the short form-12 survey (PCS-12), mental component score of the short form-12 survey (MCS-12), and Oswestry Disability Index (ODI), were identified and compared between groups using univariate and multivariate analysis.

RESULTS: There were no significant differences in preoperative, postoperative, or delta scores for PCS-12 or ODI scores between groups. In patients undergoing decompression surgery, those with back pain-dominant or mixed symptoms (B, N, or NLPD groups) did not improve with respect to MCS-12 scores after surgery (

CONCLUSION: Patients undergoing lumbar decompression surgery and leg pain-dominant symptoms noted a greater improvement in MCS-12 scores; however, there were no differences in PCS-12 or ODI scores.

LEVEL OF EVIDENCE: 3.

CLINICAL RELEVANCE: Patients undergoing lumbar decompression surgery demonstrate no major clinically significant differences when split up by pain-dominance groups.

Volume

15

Issue

4

First Page

780

Last Page

787

ISSN

2211-4599

Published In/Presented At

Divi, S. N., Woods, B. I., Goyal, D. K. C., Galetta, M. S., Nicholson, K. J., Dimatteo, A. L., Lam, M. E., Qureshi, M. A., Anderson, D. G., Kurd, M. F., Rihn, J. A., Kaye, I. D., Kepler, C. K., Hilibrand, A. S., Vaccaro, A. R., Radcliff, K. E., & Schroeder, G. D. (2021). Do Patients with Back Pain-Dominant Symptoms Improve After Lumbar Surgery for Radiculopathy or Claudication?. International journal of spine surgery, 15(4), 780–787. https://doi.org/10.14444/8100

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

34266928

Department(s)

Administration and Leadership

Document Type

Article