Pre-operative leg and back pain and work status are important considerations to inform decisions for management following surgery. Model performance demonstrated reasonable to good calibration and adequate/very good discrimination.ConclusionsBMI, ODI, leg and back pain and previous surgery are important considerations pre-operatively to inform decisions for surgery. Working and higher leg pain were predictive of good ODI and leg pain outcomes, higher back pain was predictive of good back pain outcome, and higher leg pain was predictive of good leg pain outcome at 12 months. Linear and logistic regression models were fitted and regression coefficients, Odds ratios and 95% CIs reported.ResultsLower BMI, higher ODI and higher leg pain pre-operatively were predictive of good disability outcome, higher back pain was predictive of good back pain outcome, and no previous surgery and higher leg pain were predictive of good leg pain outcome all at 6 weeks. Definition of good outcome (6 weeks, 12 months) was reduction in pain intensity (Numerical Rating Scale, 0-10) and disability (Oswestry Disability Index, ODI 0-50) > 1.7 and 14.3, respectively. The objective was to develop clinical prediction rules to identify which patients are likely to have a favourable outcome to inform decisions regarding surgery and rehabilitation.MethodsA prospective observational study recruited 600 (derivation) and 600 (internal validation) consecutive adult patients undergoing LSFS for degenerative lumbar disorder through the British Spine Registry. Findings may inform clinical decision making regarding LSFS and associated rehabilitation.Ībstract = "PurposeLumbar spinal fusion surgery (LSFS) is common for lumbar degenerative disorders. Viewed from the side of the body, the spine has the shape of a gentle double S curve.PurposeLumbar spinal fusion surgery (LSFS) is common for lumbar degenerative disorders. Below the lumbar vertebrae, the spine terminates with two groups of vertebrae fused into single bones: the sacrum, composed of five vertebrae, and the coccyx, composed of four vertebrae. Below these are the 12 thoracic vertebrae, the supports on which the ribs are hinged, and then the five lumbar vertebrae, the largest movable vertebrae (the cervical are the smallest). The head turns from side to side by means of a pivotal motion between the two highest vertebrae. The topmost are the seven cervical vertebrae, which form the back of the neck, supporting the skull. There are usually 24 movable vertebrae and nine that are fused together. In the areas of the neck and lower back, the spine also can pivot, which permits the turning of the head and torso. The vertebrae also provide the protective bony corridor ( spinal canal) through which the spinal cord passes they can move to a certain extent and so give flexibility to the spine, allowing it to bend forward, sideways and, to a lesser extent, backward. The spinal column is the axis of the skeleton the skull and limbs are in a sense appendages. the rigid bony structure in the midline of the back, composed of the vertebrae called also backbone, spinal column, and vertebral column.
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