Prognostic models of the severity of acute dynamic pain on the first postoperative day and the likelihood of chronic postoperative pain in spine surgery

Genov, P.; Тимербаев, В. Х.; Долгашева, Н С; Efanov, A. A.; Grin, A. A.; Rebrova, O. Yu.

doi:10.17116/neiro201882329

Cited by 2 publications

(2 citation statements)

References 6 publications

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“…Interestingly, our analysis revealed that lower age was significantly associated with worse COMI outcomes after 3 weeks postoperatively. This is contrary to other findings which show no significant association [ 36 ] or an inverse association between age and PROMs after spine surgery 51–54 [ 37 , 38 , 39 , 40 ]. However, our data is in accordance with the findings of one of the largest predictive studies in spine surgery, involving 15 hospitals and 1965 surgical patients [ 41 ].…”

Section: Discussioncontrasting

confidence: 99%

One-Year Clinical Outcomes of Minimal-Invasive Dorsal Percutaneous Fixation of Thoracolumbar Spine Fractures

et al. 2022

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Introduction: Minimal-invasive instrumentation techniques have become a workhorse in spine surgery and require constant clinical evaluations. We sought to analyze patient-reported outcome measures (PROMs) and clinicopathological characteristics of thoracolumbar fracture stabilizations utilizing a minimal-invasive percutaneous dorsal screw-rod system. Methods: We included all patients with thoracolumbar spine fractures who underwent minimal-invasive percutaneous spine stabilization in our clinics since inception and who have at least 1 year of follow-up data. Clinical characteristics (length of hospital stay (LOS), operation time (OT), and complications), PROMs (preoperative (pre-op), 3-weeks postoperative (post-op), 1-year postoperative: eq5D, COMI, ODI, NRS back pain), and laboratory markers (leucocytes, c-reactive protein (CRP)) were analyzed, finding significant associations between these study variables and PROMs. Results: A total of 68 patients (m: 45.6%; f: 54.4%; mean age: 76.9 ± 13.9) were included. The most common fracture types according to the AO classification were A3 (40.3%) and A4 (40.3%), followed by B2 (7.46%) and B1 (5.97%). The Median American Society of Anesthesiologists (ASA) score was 3 (range: 1–4). Stabilized levels ranged from TH4 to L5 (mean number of targeted levels: 4.25 ± 1.4), with TH10-L2 (12/68) and TH11-L3 (11/68) being the most frequent site of surgery. Mean OT and LOS were 92.2 ± 28.2 min and 14.3 ± 6.9 days, respectively. We observed 9/68 complications (13.2%), mostly involving screw misalignments and loosening. CRP increased from 24.9 ± 33.3 pre-op to 34.8 ± 29.9 post-op (p < 0.001), whereas leucocyte counts remained stable. All PROMs showed a marked significant improvement for both 3-week and 1-year evaluations compared to the preoperative situation. Interestingly, we did not find an impact of OT, LOS, lab markers, complications, and other clinical characteristics on PROMs. Notably, a higher number of stabilized levels did not affect PROMs. Conclusions: Minimal-invasive stabilization of thoracolumbar fractures utilizing a dorsal percutaneous approach resulted in significant PROM outcome improvements, although we observed a complication rate of 13.2% for up to 1 year of follow-up. PROMs were not significantly associated with clinicopathological characteristics, technique-related variables, or the number of targeted levels.

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Section: Discussioncontrasting

confidence: 99%

One-Year Clinical Outcomes of Minimal-Invasive Dorsal Percutaneous Fixation of Thoracolumbar Spine Fractures

et al. 2022

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“…We included studies in patients undergoing cervical spine (n = 3), thoracolumbar spine (n = 2), and lumbar spine (n = 8) surgery [3••, 5••, 6••, [23][24][25][26][27][28][29][30][31][32]. These studies reported predictive models (n = total number of models) to estimate post-surgical patient-reported outcomes of the following: return to work (n = 3), pain (n = 9), physical functioning and disability (n = 5), quality of life (QOL) (n = 6), and psychosocial disposition (n = 2) reported in Table 4.…”

Section: Predicted Patient-reported Outcomes By Spine Regionmentioning

confidence: 99%

Predicting Patient-Centered Outcomes from Spine Surgery Using Risk Assessment Tools: a Systematic Review

White

Bradley

Hadgis

et al. 2020

Curr Rev Musculoskelet Med

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Purpose of Review The purpose of this systematic review is to evaluate the current literature in patients undergoing spine surgery in the cervical, thoracic, and lumbar spine to determine the available risk assessment tools to predict the patient-centered outcomes of pain, disability, physical function, quality of life, psychological disposition, and return to work after surgery. Recent Findings Risk assessment tools can assist surgeons and other healthcare providers in identifying the benefit-risk ratio of surgical candidates. These tools gather demographic, medical history, and other pertinent patient-reported measures to calculate a probability utilizing regression or machine learning statistical foundations. Currently, much is still unknown about the use of these tools to predict quality of life, disability, and other factors following spine surgery. A systematic review was conducted using PRISMA guidelines that identified risk assessment tools that utilized patient-reported outcome measures as part of the calculation. From 8128 identified studies, 13 articles met inclusion criteria and were accepted into this review. Summary The range of c-index values reported in the studies was between 0.63 and 0.84, indicating fair to excellent model performance. Post-surgical patient-reported outcomes were identified in the following categories (n = total number of predictive models): return to work (n = 3), pain (n = 9), physical functioning and disability (n = 5), quality of life (QOL) (n = 6), and psychosocial disposition (n = 2). Our review has synthesized the available evidence on risk assessment tools for predicting patient-centered outcomes in patients undergoing spine surgery and described their findings and clinical utility.

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Prognostic models of the severity of acute dynamic pain on the first postoperative day and the likelihood of chronic postoperative pain in spine surgery

Abstract: The developed software in the form of MS Excel calculators provides a particular patient with preoperative assessment of the risk for minor acute dynamic pain on the 1 postoperative day and CPS 5-7 months after surgery.

Cited by 2 publications

References 6 publications

One-Year Clinical Outcomes of Minimal-Invasive Dorsal Percutaneous Fixation of Thoracolumbar Spine Fractures

One-Year Clinical Outcomes of Minimal-Invasive Dorsal Percutaneous Fixation of Thoracolumbar Spine Fractures

Predicting Patient-Centered Outcomes from Spine Surgery Using Risk Assessment Tools: a Systematic Review

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