Considerations in Spinal Fusion Surgery for Chronic Lumbar Pain: Psychosocial Factors, Rating Scales, and Perioperative Patient Education—A Review of the Literature

Gaudin, Daniel; Krafcik, Brianna M.; Mansour, Tarek R; Alnemari, Ahmed

doi:10.1016/j.wneu.2016.10.124

Cited by 24 publications

(17 citation statements)

References 65 publications

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“…The finding that gender, BMI, previous back surgery, leg pain intensity, comorbidities, pain in the thoracic spine, somatization, treatment expectations, and walking distance were predictive of spinal surgery referral is in line with previous studies showing that they are also indicative of spinal surgery outcome [12,[19][20][21][22][23]. This can be interpreted as that surgeons are aware of and adhere to some extent to the current literature and (international) guidelines.…”

Section: Comparison With the Literaturesupporting

confidence: 88%

“…On the contrary, CLBP patients with comorbidities were found to be less likely to be referred to surgery than those without comorbidities. This too suggests that the surgeons referred in line with the current scientific evidence, as comorbidities are an important risk factor for surgery [12,19,21,22].…”

Section: Comparison With the Literaturementioning

confidence: 67%

“…This can be interpreted as that surgeons are aware of and adhere to some extent to the current literature and (international) guidelines. In a recent literature review, for example, Gaudin et al found patient reports of good health and low cardiovascular comorbidity to be the two most powerful preoperative predictors of a better spinal fusion outcome [12]. Also, CLBP patients who expect to be complaint free after treatment were found to be more likely to be referred to spinal surgery than those who still expect to experience complaints.…”

Section: Comparison With the Literaturementioning

confidence: 99%

“…Amongst others, it would be insightful to know which CLBP patients are typically referred to spinal surgery, whether patient-reported factors can be identified that are predictive of spinal surgery referral, and if so, to what extent spinal surgery referral is explained by these factors. Nonetheless, even though numerous studies have investigated predictive factors of spine surgery outcome, little research has focused on identifying patientreported factors that are predictive of referral to spinal surgery [11,12].…”

Section: Introductionmentioning

confidence: 99%

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Which patient-reported factors predict referral to spinal surgery? A cohort study among 4987 chronic low back pain patients

et al. 2017

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Purpose It is unknown which chronic low back pain (CLBP) patients are typically referred to spinal surgery. The present study, therefore, aimed to explore which patient-reported factors are predictive of spinal surgery referral among CLBP patients. Methods CLBP patients were consecutively recruited from a Dutch orthopedic hospital specialized in spine care (n = 4987). The outcome of this study was referral to spinal surgery (yes/no), and was assessed using hospital records. Possible predictive factors were assessed using a screening questionnaire. A prediction model was constructed using logistic regression, with backwards selection and p \ 0.10 for keeping variables in the model. The model was internally validated and evaluated using discrimination and calibration measures.Results Female gender, previous back surgery, high intensity leg pain, somatization, and positive treatment expectations increased the odds of being referred to spinal surgery, while being obese, having comorbidities, pain in the thoracic spine, increased walking distance, and consultation location decreased the odds. The model's fit was good (X 2 = 10.5; p = 0.23), its discriminative ability was poor (AUC = 0.671), and its explained variance was low (5.5%). A post hoc analysis indicated that consultation location was significantly associated with spinal surgery referral, even after correcting for case-mix variables. Conclusion Some patient-reported factors could be identified that are predictive of spinal surgery referral. Although the identified factors are known as common predictive factors of surgery outcome, they could only partly predict spinal surgery referral.

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Section: Comparison With the Literaturesupporting

confidence: 88%

Section: Comparison With the Literaturementioning

confidence: 67%

Section: Comparison With the Literaturementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Which patient-reported factors predict referral to spinal surgery? A cohort study among 4987 chronic low back pain patients

et al. 2017

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“…[30]). In addition, psychosocial factors have been implicated in outcomes of surgical procedures, for example, chronic pain [31]; lumbar and spinal surgery [32][33][34][35][36][37][38]; liver transplant (e.g. [39]) and coronary artery bypass (e.g.…”

Section: Emerging Evidence Of Psychosocial Causationmentioning

confidence: 99%

The Biopsychosocial Model 40 Years On

Bolton

Gillett

2019

The Biopsychosocial Model of Health and Disease

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The first chapter outlines George Engel's proposal of a new biopsychosocial model for medicine and healthcare in papers 40 years ago and reviews its current status. The model is popular and much invoked in clinical and health education settings and has claim to be the overarching framework for contemporary healthcare. On the other hand, the model has been increasingly criticised for being vague, useless, and even incoherent-clinically, scientifically and philosophically. The combination of these two points signifies something of a crisis in the conceptual foundations of medicine and healthcare. We outline some of the emerging evidence implicating psychosocial as well as biological factors in health and disease, and propose the following solution to the vagueness problem: that the scientific and clinical content of the model relates to specific conditions and stages of conditions, so that there is, for example, a biopsychosocial model of cardiovascular disease, diabetes or depression. Much the same point applies to the narrower biomedical model. However this raises the question: what is the point of having a general model? Our response is that it is needed to theorise biopsychosocial interactions in health and disease. In the light of historical prejudices against psychosocial causation deriving from physicalist reductionism and dualism, recognised by Engel and current commentators on the biopsychosocial model, this is a non-trivial task that occupies subsequent chapters. Engel's Proposed Improvement on the Biomedical ModelIn his classic paper published in 1977 George Engel proposed a new model for medicine, the biopsychosocial model, contrasted with the existing biomedical model [1]. While recognising the great advances in biomedicine, Engel argued that nevertheless the biomedical model was limited, and insufficient for many aspects of medical science and healthcare. These limitations were extensive, comprising failure to take account of the following: the person who has the illness, the person's experience of, account of and attitude towards the illness; whether the person or others in fact regard the condition as an illness; care of the patient as a person; for some conditions such as schizophrenia and diabetes, the effect of conditions of living on onset, presentation and course; and finally, the healthcare system itself also cannot be conceptualised solely in biomedical terms but rather involves social factors such as professionalisation ([1], pp. 131-135). Engel argued that a broadening of the biomedical approach, a new biopsychosocial model, was needed to take account of all these factors 'contributing to both illness and patienthood' ([1], p. 133). The Presumed 'Overarching Framework'In his review of a recent book on the biopsychosocial model by Nassir Ghaemi [2], in The American Journal of Psychiatry, Kenneth Kendler starts with the sentence: "This book is about a very important topicthe overarching conceptual framework of our field of psychiatry" ([3], p. 999).Whether the biopsychosocial model has this s...

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Perioperative Considerations for Patients With Major Depressive Disorder Undergoing Surgery

Aroke

Robinson

Wilbanks

2020

Journal of PeriAnesthesia Nursing

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Considerations in Spinal Fusion Surgery for Chronic Lumbar Pain: Psychosocial Factors, Rating Scales, and Perioperative Patient Education—A Review of the Literature

Cited by 24 publications

References 65 publications

Which patient-reported factors predict referral to spinal surgery? A cohort study among 4987 chronic low back pain patients

Which patient-reported factors predict referral to spinal surgery? A cohort study among 4987 chronic low back pain patients

The Biopsychosocial Model 40 Years On

Perioperative Considerations for Patients With Major Depressive Disorder Undergoing Surgery

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