Role of psychosocial factors on the effect of physical activity on physical function in patients after lumbar spine surgery.

Background: The purpose of this study was to investigate the longitudinal postoperative relationship between physical activity, psychosocial factors, and physical function in patients undergoing lumbar spine surgery.

Methods: We enrolled 248 participants undergoing surgery for a degenerative lumbar spine condition. Physical activity was measured using a triaxial accelerometer (Actigraph GT3X) at 6-weeks (6wk), 6-months (6M), 12-months (12M) and 24-months (24M) following spine surgery.

How Many Steps Per Day During the Early Postoperative Period are Associated With Patient-Reported Outcomes of Disability, Pain, and Opioid Use After Lumbar Spine Surgery?

Objective: To investigate whether early postoperative walking is associated with "best outcome" and no opioid use at 1 year after lumbar spine surgery and establish a threshold for steps/day to inform clinical practice.

Design: Secondary analysis from randomized controlled trial.

Setting: Two academic medical centers in the United States.

Early postoperative physical activity and function: a descriptive case series study of 53 patients after lumbar spine surgery.

Background: The purpose of this prospective case series study was to compare changes in early postoperative physical activity and physical function between 6 weeks and 3 and 6 months after lumbar spine surgery.

Methods: Fifty-three patients (mean [95% confidence interval; CI] age = 59.2 [56.

Physical Performance Tests Provide Distinct Information in Both Predicting and Assessing Patient-Reported Outcomes Following Lumbar Spine Surgery.

Study Design: Secondary analysis of randomized controlled trial data.

Objective: The aim of this study was to examine whether preoperative physical performance is an independent predictor of patient-reported disability and pain at 12 months after lumbar spine surgery.

Summary Of Background Data: Patient-reported outcome measures (PROMs) are commonly used to assess clinical improvement after lumbar spine surgery.

Bouncing back after lumbar spine surgery: early postoperative resilience is associated with 12-month physical function, pain interference, social participation, and disability.

Background Context: Positive psychosocial factors early after surgery, such as resilience and self-efficacy, may be important characteristics for informing individualized postoperative care.

Purpose: To examine the association of early postoperative resilience and self-efficacy on 12-month physical function, pain interference, social participation, disability, pain intensity, and physical activity after lumbar spine surgery.

Study Design/setting: Pooled secondary analysis of prospectively collected trial data from two academic medical centers.

Psychosocial Mechanisms of Cognitive-Behavioral-Based Physical Therapy Outcomes After Spine Surgery: Preliminary Findings From Mediation Analyses.

Objective: Changing Behavior through Physical Therapy (CBPT), a cognitive-behavioral-based program, has been shown to improve outcomes after lumbar spine surgery in patients with a high psychosocial risk profile; however, little is known about potential mechanisms associated with CBPT treatment effects. The purpose of this study was to explore potential mediators underlying CBPT efficacy after spine surgery.

Methods: In this secondary analysis, 86 participants were enrolled in a randomized trial comparing a postoperative CBPT (n = 43) and education program (n = 43).

Safety and feasibility of an early telephone-supported home exercise program after anterior cervical discectomy and fusion: a case series.

: To describe the safety, feasibility, and preliminary outcomes of an early telephone-supported home exercise program (HEP) performed within the first 6 weeks after anterior cervical discectomy and fusion (ACDF) surgery.: Eight patients (mean ± SD age = 53.4 ± 14.

Early Self-directed Home Exercise Program After Anterior Cervical Discectomy and Fusion: A Pilot Study.

Study Design: Pilot randomized controlled trial.

Objective: To examine the acceptability and preliminary safety and outcome effects of an early self-directed home exercise program (HEP) performed within the first 6 weeks after anterior cervical discectomy and fusion (ACDF).

Summary Of Background Data: Little is known regarding optimal postoperative management after ACDF.

Drivers of Variability in 90-day Cost for Primary Single-level Microdiscectomy.

Background: The healthcare reimbursement models are rapidly transitioning to pay-per-performance episode of care payment models. These models, if designed well, must account for the variability in the cost of index surgeries during the global period.

Objective: To analyze the variability in 90-d cost and determine the drivers of the variability in total 90-d cost associated with single-level microdiscectomy.

Are Low Patient Satisfaction Scores Always Due to the Provider?: Determinants of Patient Satisfaction Scores During Spine Clinic Visits.

Study Design: A prospective study.

Objective: The aim of this study was to investigate the impact of various components on patient satisfaction scores SUMMARY OF BACKGROUND DATA.: Patient satisfaction has become an important component of quality assessments.

Cognitive-Behavioral-Based Physical Therapy for Patients With Chronic Pain Undergoing Lumbar Spine Surgery: A Randomized Controlled Trial.

Unlabelled: The purpose of this study was to determine the efficacy of a cognitive-behavioral-based physical therapy (CBPT) program for improving outcomes in patients after lumbar spine surgery. A randomized controlled trial was conducted on 86 adults undergoing a laminectomy with or without arthrodesis for a lumbar degenerative condition. Patients were screened preoperatively for high fear of movement using the Tampa Scale for Kinesiophobia.

A comparative effectiveness trial of postoperative management for lumbar spine surgery: changing behavior through physical therapy (CBPT) study protocol.

Background: The United States has the highest rate of lumbar spine surgery in the world, with rates increasing over 200% since 1990. Medicare spends over $1 billion annually on lumbar spine surgery. Despite surgical advances, up to 40% of patients report chronic pain and disability following surgery.

Long-term outcomes after revision neural decompression and fusion for same-level recurrent lumbar stenosis: defining the effectiveness of surgery.

Study Design: Single-cohort study of patients undergoing revision neural decompression and fusion for same-level recurrent lumbar stenosis.

Objective: To assess the long-term outcomes of revision surgery using validated patient-reported outcomes measures.

Summary Of Background Data: Recurrent lumbar stenosis may occur after lumbar spine surgery, leading to significant discomfort and radicular pain.

Cost per quality-adjusted life year gained of revision fusion for lumbar pseudoarthrosis: defining the value of surgery.

Study Design: Single cohort study of patients undergoing revision fusion for lumbar pseudoarthrosis.

Objective: To assess the 2-year comprehensive costs of revision arthrodesis for lumbar pseudoarthrosis at our institution and determine the associated cost per quality-adjusted life year (QALY) gained in this patient population.

Summary Of Background Data: The proportion of lumbar spine operations involving a fusion procedure has increased over the past 2 decades.

Cognitive-behavioral-based physical therapy to improve surgical spine outcomes: a case series.

Background And Purpose: Fear of movement is a risk factor for poor postoperative outcomes in patients following spine surgery. The purposes of this case series were: (1) to describe the effects of a cognitive-behavioral-based physical therapy (CBPT) intervention in patients with high fear of movement following lumbar spine surgery and (2) to assess the feasibility of physical therapists delivering cognitive-behavioral techniques over the telephone.

Case Description: Eight patients who underwent surgery for a lumbar degenerative condition completed the 6-session CBPT intervention.

Laminectomy and extension of instrumented fusion improves 2-year pain, disability, and quality of life in patients with adjacent segment disease: defining the long-term effectiveness of surgery.

Objective: Adjacent segment disease (ASD) may occur as a long-term consequence of spinal fusion and is associated with significant back and leg pain. Surgical management of symptomatic ASD consists of neural decompression and extension of fusion. However, conflicting results have been reported with respect to the long-term clinical effectiveness of revision surgery in this setting.

Association of extent of local tumor invasion and survival in patients with malignant primary osseous spinal neoplasms from the surveillance, epidemiology, and end results (SEER) database.

Background: Malignant osseous spinal neoplasms are aggressive tumors associated with poor outcomes despite aggressive multidisciplinary measures. It remains unknown whether increased local tumor invasion at time of treatment predicts worse survival. The surveillance, epidemiology, and end results (SEER) registry was reviewed to determine whether extent of local tumor invasion at presentation was independently associated with overall survival.

Cauda equina syndrome secondary to an absent inferior vena cava managed with surgical decompression.

The authors report on the case of a 24-year-old man who presented with back pain and radiculopathy due to epidural venous engorgement in the setting of a congenitally absent inferior vena cava. Despite initial improvement after steroid administration, the patient's health ultimately declined over a period of weeks, and signs and symptoms of cauda equina syndrome manifested. Lumbar decompression was performed and involved coagulation and resection of the compressive epidural veins.

Cost per quality-adjusted life year gained of revision neural decompression and instrumented fusion for same-level recurrent lumbar stenosis: defining the value of surgical intervention.

Object: Despite advances in technology and understanding in spinal physiology, reoperation for symptomatic same-level recurrent stenosis continues to occur. Although revision lumbar surgery is effective, attention has turned to the question of the utility and value of revision decompression and fusion procedures. To date, an analysis of cost and heath state gain associated with revision lumbar surgery for recurrent same-level lumbar stenosis has yet to be described.

Cost-utility analysis of minimally invasive versus open multilevel hemilaminectomy for lumbar stenosis.

Study Design: Two-year cost-utility study comparing minimally invasive (MIS) versus open multilevel hemilaminectomy in patients with degenerative lumbar spinal stenosis.

Objective: The objective of the study was to determine whether MIS versus open multilevel hemilaminectomy for degenerative lumbar spinal stenosis is a cost-effective advancement in lumbar decompression surgery.

Summary Of Background Data: MIS-multilevel hemilaminectomy for degenerative lumbar spinal stenosis allows for effective treatment of back and leg pain while theoretically minimizing blood loss, tissue injury, and postoperative recovery.

Preoperative Zung Depression Scale predicts outcome after revision lumbar surgery for adjacent segment disease, recurrent stenosis, and pseudarthrosis.

Background Context: Persistent back pain and leg pain after index surgery is distressing to patients and spinal surgeons. Revision surgical treatment is technically challenging and has been reported to yield unpredictable outcomes. Recently, affective disorders, such as depression and anxiety, have been considered potential predictors of surgical outcomes across many disease states of chronic pain.

Long-term outcomes of revision fusion for lumbar pseudarthrosis: clinical article.

Object: The number of low-back fusion procedures for the treatment of spine disorders has increased steadily over the past 10 years. Lumbar pseudarthrosis is a potential complication of lumbar arthrodesis and can be associated with significant pain and disability. The aim of this study was to assess, using validated patient-reported outcomes measures, the long-term effectiveness of revision arthrodesis in the treatment of symptomatic pseudarthrosis.

Cost-effectiveness of multilevel hemilaminectomy for lumbar stenosis-associated radiculopathy.

Background Context: Laminectomy for lumbar stenosis-associated radiculopathy is associated with improvement in pain, disability, and quality of life. However, given rising health-care costs, attention has been turned to question the cost-effectiveness of lumbar decompressive procedures. The cost-effectiveness of multilevel hemilaminectomy for radiculopathy remains unclear.

Cost-effectiveness of transforaminal lumbar interbody fusion for Grade I degenerative spondylolisthesis.

Object: Transforaminal lumbar interbody fusion (TLIF) for spondylolisthesis-associated back and leg pain is associated with improvement in pain, disability, and quality of life. However, given the rising health care costs associated with spinal fusion procedures and varying results of recent cost-utility studies, the cost-effectiveness of TLIF remains unclear. The authors set out to assess the comprehensive costs of TLIF at their institution and to determine its cost-effectiveness in the treatment of degenerative spondylolisthesis.

Utility of minimum clinically important difference in assessing pain, disability, and health state after transforaminal lumbar interbody fusion for degenerative lumbar spondylolisthesis.

Object: Outcome studies for spine surgery rely on patient-reported outcomes (PROs) to assess treatment effects. Commonly used health-related quality-of-life questionnaires include the following scales: back pain and leg pain visual analog scale (BP-VAS and LP-VAS); the Oswestry Disability Index (ODI); and the EuroQol-5D health survey (EQ-5D). A shortcoming of these questionnaires is that their numerical scores lack a direct meaning or clinical significance.