Disability and pain after lumbar surgery-group-based trajectory analysis

Area of Science:

• Spine Surgery Outcomes
• Patient Reported Outcome Measures (PROMs)
• Health Services Research

Background:

• Traditional lumbar spine surgery studies focus on average outcomes, neglecting subgroup variations.
• Understanding distinct patient trajectories and predictive factors is crucial for personalized care.

Purpose of the Study:

• Identify distinct outcome trajectories in lumbar spine surgery patients.
• Determine preoperative factors influencing these trajectories.

Main Methods:

• Register-based study of 1,451 lumbar spine surgery patients.
• Group-based trajectory analysis for leg pain, back pain, and function.
• Probability analysis based on sex, age, pain duration, and obesity.

Main Results:

• Two trajectory groups identified: short-term and long-term improvement.
• Obesity associated with poorer outcomes across all variables (RRR 1.26-1.45).
• Preoperative pain duration linked to back pain severity (RRR 1.28).

Conclusions:

• Lumbar surgery generally improves pain and function for up to two years.
• Higher BMI and preoperative pain/disability predict inferior outcomes.
• Informed planning for rehabilitation and medication is needed for at-risk patients.