Predictors of outcome after surgery with disc prosthesis and rehabilitation in patients with chronic low back pain and degenerative disc: 2-year follow-up

Abstract

Purpose A prospective study to evaluate whether certain baseline characteristics can predict outcome in patients treated with disc prosthesis or multidisciplinary rehabilitation. Methods Secondary analysis of 154 patients with chronic low back pain (LBP) for at least 1 year and degenerative discs originally recruited for a randomized trial. Outcome measures were Oswestry Disability Index (ODI) dichotomized to \ or C15 points improvement and whether subjects were working at 2-year follow-up. A multiple logistic regression analysis was used. Results In patients treated with disc prosthesis, long duration of LBP and high Fear-Avoidance Beliefs for work (FABQ-W) predicted worse ODI outcome [odds ratio (OR) = 1.9, 95% confidence interval (CI) 1.2-3.2 and OR = 1.7, CI 1.2-2.4 for every 5 years or 5 points]. Modic type I or II predicted better ODI outcome (OR = 5.3, CI

Does magnetic resonance imaging predict future low back pain? A systematic review

“…A table of excluded full‐text articles and the primary reason for exclusion is included in http://onlinelibrary.wiley.com/doi/10.1002/j.1532-2149.2013.00427.x/suppinfo. Therefore, 13 studies met all the inclusion criteria (Borenstein et al., ; Elfering et al., ; Carragee et al., , ,b; Jarvik et al., ; Modic et al., ; Kleinstuck et al., ; McNee et al., ; Hellum et al., ; Jensen et al., ; Keller et al., ) (Fig. ).…”

“…ORs and 95% CI were calculated from the extracted raw data for the following studies (Boos et al., ; Elfering et al., ; Carragee et al., ; McNee et al., ; Hellum et al., ; Jensen et al., ).…”

“…The association of Modic changes with LBP (Kleinstuck et al., ; Jensen et al., ; Keller et al., ) and with disability (Kleinstuck et al., ; Hellum et al., ; Keller et al., ) was investigated by four studies. Jensen et al.…”

The Michel Benoist and Robert Mulholland yearly European Spine Journal Review

“…The problem is how to choose between these two alternatives. In this regard, I strongly recommend a careful reading of the paper by Hellum et al [14] published in April, which yields interesting new information. The high-quality study aimed at evaluating whether some baseline characteristics could predict outcome in patients treated either by intensive rehabilitation or by disc prosthesis.…”

The Michel Benoist and Robert Mulholland yearly European Spine Journal Review

“…However, intensive rehabilitation has also been shown to be an option. Disc replacement has not proved to be the dramatic success we had hoped, so the review article by Hellum [24] ''Predictors of outcome after surgery with disc prosthesis and rehabilitation in patients with low back pain'' is welcome. It was a prospective study to evaluate whether certain baseline characteristics can predict outcome in patients treated with disc prosthesis or with rehabilitation.…”