The Impact of Reduction of Pain After Lumbar Spine Surgery: The Relationship Between Changes in Pain and Physical Function and Disability

STUDY DESIGN.Prospective cohort study. OBJECTIVE.To examine the relationship between improvement in pain intensity and subsequent improvement in physical function and disability during the first 12 months after lumbar spine surgery. SUMMARY OF BACKGROUND DATA.Little is known about how reduction of p...

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Veröffentlicht in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 2014-08, Vol.39 (17), p.1426-1432
Hauptverfasser: Skolasky, Richard L, Wegener, Stephen T, Maggard, Anica M, Riley, Lee H
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container_end_page 1432
container_issue 17
container_start_page 1426
container_title Spine (Philadelphia, Pa. 1976)
container_volume 39
creator Skolasky, Richard L
Wegener, Stephen T
Maggard, Anica M
Riley, Lee H
description STUDY DESIGN.Prospective cohort study. OBJECTIVE.To examine the relationship between improvement in pain intensity and subsequent improvement in physical function and disability during the first 12 months after lumbar spine surgery. SUMMARY OF BACKGROUND DATA.Little is known about how reduction of pain intensity after surgery may predict improvements in physical function and disability. METHODS.We prospectively enrolled 260 individuals undergoing elective surgery for degenerative lumbar spine conditions from August 2005 through August 2011. Preoperative and postoperative (3, 6, and 12 mo) assessment tools were numeric pain rating scale, Short Form 12 version 2 physical component score (physical function), and Oswestry Disability Index (disability). Changes were defined using minimum clinically important differences. The association between improvement in pain intensity and subsequent improvement in physical function and disability during the first 12 postoperative months was assessed using standard regression methods. Significance was set at a P value less than 0.05. RESULTS.Preoperatively, mean pain intensity was 5.2 (standard deviation, 2.4), physical function was 27.9 (standard deviation, 9.2), and disability was 40.1% (standard deviation, 16.8%). Pain intensity had improved in 164 (63.1%) patients by 3 and 6 months and in 184 (70.8%) by 12 months. Patients with improvement in pain postoperatively were more likely to have subsequent improvement in physical function (odds ratio, 2.11; 95% confidence interval, 1.10–3.16) during the course of 12 postoperative months. The association between postoperative pain reduction and reduced disability was similar (odds ratio, 1.61; confidence interval, 1.12–2.33). CONCLUSION.Most patients experienced clinically important postsurgical reductions in pain intensity by 3 months after surgery. Those patients were more likely to have clinically important improvement in physical function and reduction in disability during the first postoperative year.Level of Evidence1
doi_str_mv 10.1097/BRS.0000000000000428
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OBJECTIVE.To examine the relationship between improvement in pain intensity and subsequent improvement in physical function and disability during the first 12 months after lumbar spine surgery. SUMMARY OF BACKGROUND DATA.Little is known about how reduction of pain intensity after surgery may predict improvements in physical function and disability. METHODS.We prospectively enrolled 260 individuals undergoing elective surgery for degenerative lumbar spine conditions from August 2005 through August 2011. Preoperative and postoperative (3, 6, and 12 mo) assessment tools were numeric pain rating scale, Short Form 12 version 2 physical component score (physical function), and Oswestry Disability Index (disability). Changes were defined using minimum clinically important differences. The association between improvement in pain intensity and subsequent improvement in physical function and disability during the first 12 postoperative months was assessed using standard regression methods. Significance was set at a P value less than 0.05. RESULTS.Preoperatively, mean pain intensity was 5.2 (standard deviation, 2.4), physical function was 27.9 (standard deviation, 9.2), and disability was 40.1% (standard deviation, 16.8%). Pain intensity had improved in 164 (63.1%) patients by 3 and 6 months and in 184 (70.8%) by 12 months. Patients with improvement in pain postoperatively were more likely to have subsequent improvement in physical function (odds ratio, 2.11; 95% confidence interval, 1.10–3.16) during the course of 12 postoperative months. The association between postoperative pain reduction and reduced disability was similar (odds ratio, 1.61; confidence interval, 1.12–2.33). CONCLUSION.Most patients experienced clinically important postsurgical reductions in pain intensity by 3 months after surgery. Those patients were more likely to have clinically important improvement in physical function and reduction in disability during the first postoperative year.Level of Evidence1</description><identifier>ISSN: 0362-2436</identifier><identifier>EISSN: 1528-1159</identifier><identifier>DOI: 10.1097/BRS.0000000000000428</identifier><identifier>PMID: 24859574</identifier><language>eng</language><publisher>United States: by Lippincott Williams &amp; Wilkins</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Cohort Studies ; Disability Evaluation ; Female ; Humans ; Lumbar Vertebrae - physiopathology ; Lumbar Vertebrae - surgery ; Male ; Middle Aged ; Neurosurgical Procedures - methods ; Pain ; Pain Management ; Pain Measurement ; Pain, Postoperative - therapy ; Prospective Studies ; Quality of Life ; Surveys and Questionnaires</subject><ispartof>Spine (Philadelphia, Pa. 1976), 2014-08, Vol.39 (17), p.1426-1432</ispartof><rights>2014 by Lippincott Williams &amp; Wilkins</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2908-1665b1c6b3dc62670116591cdd490f927880b5573f7a6de111a614d7a121104c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24859574$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Skolasky, Richard L</creatorcontrib><creatorcontrib>Wegener, Stephen T</creatorcontrib><creatorcontrib>Maggard, Anica M</creatorcontrib><creatorcontrib>Riley, Lee H</creatorcontrib><title>The Impact of Reduction of Pain After Lumbar Spine Surgery: The Relationship Between Changes in Pain and Physical Function and Disability</title><title>Spine (Philadelphia, Pa. 1976)</title><addtitle>Spine (Phila Pa 1976)</addtitle><description>STUDY DESIGN.Prospective cohort study. OBJECTIVE.To examine the relationship between improvement in pain intensity and subsequent improvement in physical function and disability during the first 12 months after lumbar spine surgery. SUMMARY OF BACKGROUND DATA.Little is known about how reduction of pain intensity after surgery may predict improvements in physical function and disability. METHODS.We prospectively enrolled 260 individuals undergoing elective surgery for degenerative lumbar spine conditions from August 2005 through August 2011. Preoperative and postoperative (3, 6, and 12 mo) assessment tools were numeric pain rating scale, Short Form 12 version 2 physical component score (physical function), and Oswestry Disability Index (disability). Changes were defined using minimum clinically important differences. The association between improvement in pain intensity and subsequent improvement in physical function and disability during the first 12 postoperative months was assessed using standard regression methods. Significance was set at a P value less than 0.05. RESULTS.Preoperatively, mean pain intensity was 5.2 (standard deviation, 2.4), physical function was 27.9 (standard deviation, 9.2), and disability was 40.1% (standard deviation, 16.8%). Pain intensity had improved in 164 (63.1%) patients by 3 and 6 months and in 184 (70.8%) by 12 months. Patients with improvement in pain postoperatively were more likely to have subsequent improvement in physical function (odds ratio, 2.11; 95% confidence interval, 1.10–3.16) during the course of 12 postoperative months. The association between postoperative pain reduction and reduced disability was similar (odds ratio, 1.61; confidence interval, 1.12–2.33). CONCLUSION.Most patients experienced clinically important postsurgical reductions in pain intensity by 3 months after surgery. Those patients were more likely to have clinically important improvement in physical function and reduction in disability during the first postoperative year.Level of Evidence1</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cohort Studies</subject><subject>Disability Evaluation</subject><subject>Female</subject><subject>Humans</subject><subject>Lumbar Vertebrae - physiopathology</subject><subject>Lumbar Vertebrae - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neurosurgical Procedures - methods</subject><subject>Pain</subject><subject>Pain Management</subject><subject>Pain Measurement</subject><subject>Pain, Postoperative - therapy</subject><subject>Prospective Studies</subject><subject>Quality of Life</subject><subject>Surveys and Questionnaires</subject><issn>0362-2436</issn><issn>1528-1159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc9O3DAQxi3UCraUN0CVj70seJzYTnqDpQtIK4F26TlynAlx6_ypnWi1j9C3bsIuCPXQuVhj_b5vNPMRcg7sAliqLq_Xmwv2vmKeHJEZCJ7MAUT6gcxYJPmcx5E8IZ9C-DkyMoL0mJzwOBGpUPGM_HmqkN7XnTY9bUu6xmIwvW2bqXnUtqFXZY-eroY6155uOtsg3Qz-Gf3uG520a3R6EoTKdvQa-y1iQxeVbp4x0FH_YqKbgj5Wu2CNdnQ5NPsR0--NDTq3zva7z-RjqV3As8N7Sn4svz8t7uarh9v7xdVqbnjKxtWkFDkYmUeFkVwqBiBFCqYo4pSVKVdJwnIhVFQqLQsEAC0hLpQGDsBiE52Sr3vfzre_Bwx9Vttg0DndYDuEDIRgTEmp1IjGe9T4NgSPZdZ5W2u_y4BlUwjZGEL2bwij7MthwpDXWLyJXq8-Aske2LZuvG745YYt-qxC7frq_95_Afk7klU</recordid><startdate>20140801</startdate><enddate>20140801</enddate><creator>Skolasky, Richard L</creator><creator>Wegener, Stephen T</creator><creator>Maggard, Anica M</creator><creator>Riley, Lee H</creator><general>by Lippincott Williams &amp; Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140801</creationdate><title>The Impact of Reduction of Pain After Lumbar Spine Surgery: The Relationship Between Changes in Pain and Physical Function and Disability</title><author>Skolasky, Richard L ; Wegener, Stephen T ; Maggard, Anica M ; Riley, Lee H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2908-1665b1c6b3dc62670116591cdd490f927880b5573f7a6de111a614d7a121104c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cohort Studies</topic><topic>Disability Evaluation</topic><topic>Female</topic><topic>Humans</topic><topic>Lumbar Vertebrae - physiopathology</topic><topic>Lumbar Vertebrae - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neurosurgical Procedures - methods</topic><topic>Pain</topic><topic>Pain Management</topic><topic>Pain Measurement</topic><topic>Pain, Postoperative - therapy</topic><topic>Prospective Studies</topic><topic>Quality of Life</topic><topic>Surveys and Questionnaires</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Skolasky, Richard L</creatorcontrib><creatorcontrib>Wegener, Stephen T</creatorcontrib><creatorcontrib>Maggard, Anica M</creatorcontrib><creatorcontrib>Riley, Lee H</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Spine (Philadelphia, Pa. 1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Skolasky, Richard L</au><au>Wegener, Stephen T</au><au>Maggard, Anica M</au><au>Riley, Lee H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Impact of Reduction of Pain After Lumbar Spine Surgery: The Relationship Between Changes in Pain and Physical Function and Disability</atitle><jtitle>Spine (Philadelphia, Pa. 1976)</jtitle><addtitle>Spine (Phila Pa 1976)</addtitle><date>2014-08-01</date><risdate>2014</risdate><volume>39</volume><issue>17</issue><spage>1426</spage><epage>1432</epage><pages>1426-1432</pages><issn>0362-2436</issn><eissn>1528-1159</eissn><abstract>STUDY DESIGN.Prospective cohort study. OBJECTIVE.To examine the relationship between improvement in pain intensity and subsequent improvement in physical function and disability during the first 12 months after lumbar spine surgery. SUMMARY OF BACKGROUND DATA.Little is known about how reduction of pain intensity after surgery may predict improvements in physical function and disability. METHODS.We prospectively enrolled 260 individuals undergoing elective surgery for degenerative lumbar spine conditions from August 2005 through August 2011. Preoperative and postoperative (3, 6, and 12 mo) assessment tools were numeric pain rating scale, Short Form 12 version 2 physical component score (physical function), and Oswestry Disability Index (disability). Changes were defined using minimum clinically important differences. The association between improvement in pain intensity and subsequent improvement in physical function and disability during the first 12 postoperative months was assessed using standard regression methods. Significance was set at a P value less than 0.05. RESULTS.Preoperatively, mean pain intensity was 5.2 (standard deviation, 2.4), physical function was 27.9 (standard deviation, 9.2), and disability was 40.1% (standard deviation, 16.8%). Pain intensity had improved in 164 (63.1%) patients by 3 and 6 months and in 184 (70.8%) by 12 months. Patients with improvement in pain postoperatively were more likely to have subsequent improvement in physical function (odds ratio, 2.11; 95% confidence interval, 1.10–3.16) during the course of 12 postoperative months. The association between postoperative pain reduction and reduced disability was similar (odds ratio, 1.61; confidence interval, 1.12–2.33). CONCLUSION.Most patients experienced clinically important postsurgical reductions in pain intensity by 3 months after surgery. Those patients were more likely to have clinically important improvement in physical function and reduction in disability during the first postoperative year.Level of Evidence1</abstract><cop>United States</cop><pub>by Lippincott Williams &amp; Wilkins</pub><pmid>24859574</pmid><doi>10.1097/BRS.0000000000000428</doi><tpages>7</tpages></addata></record>
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source Journals@Ovid Ovid Autoload; MEDLINE
subjects Adult
Aged
Aged, 80 and over
Cohort Studies
Disability Evaluation
Female
Humans
Lumbar Vertebrae - physiopathology
Lumbar Vertebrae - surgery
Male
Middle Aged
Neurosurgical Procedures - methods
Pain
Pain Management
Pain Measurement
Pain, Postoperative - therapy
Prospective Studies
Quality of Life
Surveys and Questionnaires
title The Impact of Reduction of Pain After Lumbar Spine Surgery: The Relationship Between Changes in Pain and Physical Function and Disability
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