European Spine Journal最新文献

{"title":"Post-discharge care interventions to support patient recovery after elective degenerative spine surgery: a systematic review.","authors":"Marianne Dyrby Lorenzen, Line Adsbøll Wickstrøm, Mikkel Østerheden Andersen, Leah Yacat Carreon, Jane Clemensen, Tove Faber Frandsen","doi":"10.1007/s00586-024-08622-x","DOIUrl":"10.1007/s00586-024-08622-x","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the type, content, and results of care interventions that support spine surgery patients in their early post-discharge recovery.</p><p><strong>Methods: </strong>This systematic review was conducted according to PRISMA guidelines. The literature search was conducted in March 2022 (updated in May 2023) in MEDLINE (Ovid), EMBASE (Ovid), CINAHL (Ebsco), PsycINFO (Ovid), and Scopus. Given the heterogeneity of the interventions, outcome parameters, and controls, data for pooling for meta-analysis was not possible. We performed a thematic analysis to categorize the characteristics of the type, content, and results of care interventions.</p><p><strong>Results: </strong>A total of 14 articles met the eligibility criteria. The included studies were published between 2008 and 2022 and included 1,399 unique patients with mean reported ages of 42.3 to 62.3 years. The reported interventions were divided into two categories: \"Early active rehabilitation\" and \"Telemonitoring\". As for pain, function, quality of life, and activity the majority of the early active rehabilitation interventions showed no differences compared to usual care. In contrast, the telemonitoring interventions seemed mainly to be in favor of the interventions versus usual care in all of the aforementioned aspects.</p><p><strong>Conclusion: </strong>The included studies demonstrated diverse interventions across settings, populations, interventions, controls, follow-up times, and outcome measures. This variability suggests unclear patient needs and preferences for post-discharge care. Given the heterogeneity and overall study quality, further high-quality research is essential. Future studies should prioritize identifying these needs before intervention design.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"1042-1054"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proximal junctional disease 5 years after surgery for L4 degenerative spondylolisthesis: comparing PLIF versus minimally invasive decompression.","authors":"Masashi Tsujino, Akira Matsumura, Shoichiro Ohyama, Minori Kato, Takashi Namikawa, Yusuke Hori, Masaki Kawamura, Hiroaki Nakamura","doi":"10.1007/s00586-025-08682-7","DOIUrl":"10.1007/s00586-025-08682-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the incidence of radiological adjacent segment disease (R-ASD) at L3/4 between patients with L4/5 degenerative spondylolisthesis (DS) who underwent L4/5 posterior lumbar interbody fusion (PLIF) and those who underwent microscopic bilateral decompression via a unilateral approach (MBDU) at L4/5. Our ultimate goal was to distinguish the course of natural lumbar degeneration from fusion-related degeneration while eliminating L4/5 decompression as a confounder.</p><p><strong>Methods: </strong>Ninety patients with L4/5 DS who underwent L4/5 PLIF (n = 53) or MBDU (n = 37) and were followed for at least 5 years were retrospectively analyzed. Various radiographic parameters at L3/4 and L4/5 were measured before surgery and at last follow-up. Progression of facet degeneration was measured on computed tomography (Japanese Orthopaedic Association [JOA] classification); disc degeneration and spinal stenosis were measured on magnetic resonance imaging (Pfirrmann and Imagama classifications, respectively). R-ASD on plain radiography (X-ASD) was defined as reported by Okuda et al. [1]. R-ASD on CT or MRI (C/M-ASD) was defined as at least a one-grade progression in the relevant classification. JOA score for low back pain and incidence of reoperation were also evaluated.</p><p><strong>Results: </strong>The mean parameters at L3/4 in the PLIF group were as follows (before surgery/at last follow-up): (1) % slip: 0.8%/1.9%, (2) change in slip: 0.7/0.4 mm, (3) segmental lordosis: 11.9°/12.1°, (4) disc arc: 7.7°/7.5°, and (5) disc height: 8.6/7.7 mm. Corresponding data in the MBDU group was: (1) % slip: 1.8%/2.4%, (2) change in slip: 0.6/0.5 mm, (3) segmental lordosis: 9.6°/10.8°, (4) disc arc: 7.7°/8.7°, and (5) disc height: 7.8/6.5 mm. Disc height at last follow-up significantly differed between the groups (p = 0.002). Progression of facet degeneration was detected in 55.1% of PLIF patients and 77.8% of MBDU patients. Progression of disc degeneration and spinal stenosis was observed in 45.2% and 36.8% of PLIF patients, respectively, and 58.9% and 36.0% of MBDU patients, respectively. Overall, the incidence of X-ASD was 17.0% in the PLIF group and 16.2% in the MBDU group. Among the patients who underwent plain radiography plus CT or MRI, the total incidence of R-ASD was 70.6% in the PLIF group and 60.0% in the MBDU group. The above rates did not significantly differ between the groups. The mean improvement rate in the JOA score for low back pain was 52.8% in the PLIF group and 52.1% in the MBDU group (p = 0.867). The incidence of revision surgery at L3/4 was 1.9% in the PLIF group and 5.4% in the MBDU group (p = 0.62).</p><p><strong>Conclusion: </strong>The 5-year incidence of R-ASD at L3/4 after PLIF and MBDU in patients undergoing surgery for L4/5 DS is similar, indicating that naturally occurring lumbar degeneration is probably responsible, not fusion.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"1063-1070"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morselized corticocancellous bone as primary graft for posterior lumbar fusion: a systematic review and meta-analysis.","authors":"Ali Ahmadi Pirshahid, Asra Toobaie, Hussein Samhat, Parham Rasoulinejad, Supriya Singh, Fawaz Siddiqi, Christopher Bailey, Alla Iansavichene, Renan Rodrigues Fernandes","doi":"10.1007/s00586-024-08628-5","DOIUrl":"10.1007/s00586-024-08628-5","url":null,"abstract":"<p><strong>Purpose: </strong>Synthetic cages are commonly used in posterior and transforaminal lumbar interbody fusion procedures. Using morselized corticocancellous bone from spinous processes and laminae has been suggested as an alternative, especially in low-resource settings where access to synthetic cages is limited. The aim of this study was to compare radiographic and functional outcomes of synthetic cages with those of morselized local autograft.</p><p><strong>Methods: </strong>MEDLINE and EMBASE database search strategies were created by a medical librarian following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Screening and data extraction were performed in duplicate by two authors using predefined criteria. A meta-analysis of fusion rates, functional scores including Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI), operative time, and blood loss was performed on studies that met the selection criteria. Qualitative appraisal of post-operative disc heights and complication profile was performed. Methodological index for non-randomized studies (MINORS) criteria were used to ascertain the quality of included studies.</p><p><strong>Results: </strong>7 cohort studies were included in the finaly analysis, with 284 patients in the morselized local graft group and 276 patients in the synthetic cage group. There was no significant difference in fusion rates between the two cohorts at final follow-up (minimum 1 year; P = 0.21, I² = 30%). Likewise, no difference was seen in any of the secondary outcomes included in this meta-anlysis. Disc height at final follow-up was similar between the two cohorts in all included studies.</p><p><strong>Conclusion: </strong>Usage of morselized corticocancellous autograft to achieve interbody fusion can be a suitable alternative to synthetic cages, especially in low-resource settings where the cost of synthetic cages can be prohibitive.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"925-934"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new hernia blocking system to prevent recurrent lumbar disc herniation: surgical technique, intraoperative findings and six-months post-operative outcomes.","authors":"Oscar Godino, Carlos Fernandez-Carballal, Ignasi Català, Ángela Moreno, Jordi Manuel Rimbau, Luís Alvarez-Galovich, Héctor Roldan","doi":"10.1007/s00586-024-08595-x","DOIUrl":"10.1007/s00586-024-08595-x","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the performance and safety of a new hernia blocking system (HBS), implanted after a limited discectomy, to prevent recurrence of lumbar disc herniation.</p><p><strong>Methods: </strong>Prospective, multicenter (6 sites), cohort clinical investigation. Thirty patients with a postero-lateral disc herniation between L4-S1 and large annular defects (> 6 mm wide), who underwent a limited discectomy and were treated with a new HBS (DISC care, NEOS Surgery S.L.), were included. This article presents details about the investigational device, its surgical technique, intraoperative parameters, and up to 6 months follow-up outcomes. The primary endpoint of the study was to assess the incidence of early symptomatic reherniation. In addition, disc height, leg and back pain (NRS 0-10), Oswestry Disability Index (ODI), quality of life (EQ-5D-5L) and device safety, were evaluated.</p><p><strong>Clinicaltrials: </strong>gov: NCT04188236; date: 27th November 2019.</p><p><strong>Results: </strong>Thirty patients (43.3% female, 41.7 ± 10.9 years) were implanted with the device under evaluation in a mean of 16 ± 9.6 min. Six months after surgery, no symptomatic reherniation was detected and disc height was maintained in all patients included. All patients had a significant reduction in leg pain (> 2 points in the NRS), 92.9% improved > 15 points in the ODI and 82.6% significantly improved their quality of life (≥ 12 points in EQ VAS score). No product-related serious adverse events nor reoperations occurred.</p><p><strong>Conclusions: </strong>The implantation of an HBS is a feasible and safe procedure that prevents early disc herniation recurrence in patients at high risk of reherniation.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"1123-1133"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between NCLBP, spinal sagittal alignment and age groups: a cross-sectional cohort study.","authors":"Haoran Qi, Jingyu Wang, Chang Wang, Jianlong Li, Rongpan Dang, Jing Li","doi":"10.1007/s00586-024-08580-4","DOIUrl":"10.1007/s00586-024-08580-4","url":null,"abstract":"<p><strong>Purpose: </strong>Nonspecific chronic low back pain (NCLBP) is one of the most common manifestations of degenerative spondylitis. It affects many patients of all ages and seriously interferes with quality of life. However, the associations between NCLBP, sagittal alignment and age remain unclear. We aimed to investigate the typical features of sagittal alignment in individuals with NCLBP and to discuss the relationships between age and these NCLBP-related changes in sagittal alignment.</p><p><strong>Methods: </strong>We measured the sagittal parameters of patients with NCLBP and investigated their sagittal alignment and compensatory mechanisms by comparing them with those of asymptomatic individuals.</p><p><strong>Results: </strong>A total of 905 elderly patients (≥ 50 years old) and 1296 young patients (< 50 years old) were included. An analysis of sagittal parameters revealed that elderly patients with NCLBP had a smaller lumbar lordosis (LL, p = 0.001) and a greater T1 pelvic angle (TPA, p < 0.001). Age was significantly correlated with the TPA (r_s = 0.549, p < 0.001) and pelvic tilt (PT, r_s = 0.471, p < 0.001). The AUC value of the TPA was 0.782 (95% CI 0.764 to 0.799).</p><p><strong>Conclusions: </strong>Although decreased lumbar lordosis is the most typical sagittal feature in patients with NCLBP, there are still differences in sagittal alignment between different ages. Compared with young patients, elderly patients with NCLBP more commonly present with a decompensated pattern of the anterior inclination of the trunk as the main sagittal alignment abnormality. TPA is more predictive than LL for the diagnosis of geriatric NCLBP.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"1079-1094"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of skeletal muscle mass of the trunk and extremities on standing spine parameters before and after surgery for adult spinal deformity with a minimum 2-year follow-up.","authors":"Tetsuro Ohba, Nobuki Tanaka, Kotaro Oda, Marina Katsu, Hayato Takei, Goto Go, Hirotaka Haro","doi":"10.1007/s00586-024-08617-8","DOIUrl":"10.1007/s00586-024-08617-8","url":null,"abstract":"<p><strong>Purpose: </strong>The effect of skeletal muscle mass of the trunk and extremities on sagittal imbalance of the spine before and after surgery for adult spinal deformity (ASD) has not been elucidated. The purpose of this study was to examine the correlation between reduced skeletal muscle mass of the trunk and extremities, as well as spinopelvic parameters, preoperatively, postoperatively and at least 2 years after surgery for ASD.</p><p><strong>Methods: </strong>This retrospective observational study included 140 consecutive patients who had undergone surgery for ASD and were followed-up for at least 2 years and whose skeletal muscle mass could be measured preoperatively using whole-body dual-energy X-ray absorptiometry. Correlations between skeletal muscle mass and spinopelvic parameters were assessed preoperatively, postoperatively, and after 2 years of follow-up.</p><p><strong>Results: </strong>All spinopelvic parameters were significantly improved postoperatively compared with preoperatively. Between the postoperative period and two years post-surgery, a significant loss of correction was observed in SVA and GT. Trunk muscles mass showed significant negative correlations with preoperative PT, SS, PI-LL, SVA, GT, and TPA, but there was no significant correlation with postoperative parameters. Through univariate and multivariate regression analysis, lower limb skeletal muscle mass showed a significant negative correlation with SVA at two years postoperatively and the loss of corrected SVA (ΔSVA) over two years.</p><p><strong>Conclusion: </strong>This study revealed that lower extremity muscle mass was implicated in the loss of corrected SVA 2 years after surgery. This study is clinically meaningful as it suggests that strength training for the lower extremities, performed preoperatively and/or postoperatively, can improve sagittal imbalances of the spine in patients with severe ASD or maintain SVA after corrective surgery.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"1026-1033"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Answer to the letter to the editor of CZ Liu, et al. concerning \"Association between vertebral bone quality score and residual back pain following percutaneous vertebroplasty for osteoporotic vertebral compression fractures\" by Chen C, et al. (Eur Spine J [2024]: doi: 10.1007/s00586-024-08619-6).","authors":"Wenhua Wu","doi":"10.1007/s00586-025-08757-5","DOIUrl":"https://doi.org/10.1007/s00586-025-08757-5","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-threshold for increased risk of developing back disorders: prospective cohort with 74 000 individuals from the UK Biobank.","authors":"Rubén López-Bueno, Lars Louis Andersen, Rodrigo Núñez-Cortés, Laura López-Bueno, Luis Suso-Martí, Jorge Hugo Villafañe, Joaquín Salazar-Méndez, Joaquín Calatayud","doi":"10.1007/s00586-025-08686-3","DOIUrl":"10.1007/s00586-025-08686-3","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the prospective associations between age and the risk of low back disorders (LBD), dorsal disorders (DD), and cervical disorders (CD), and to identify a potential age-threshold for increased risk of back disorders.</p><p><strong>Methods: </strong>Prospective cohort from the UK Biobank comprising adults with no history of back disorders. We examined different ages and their association with the risk of back disorders derived from diagnoses of hospital registers. Associations were investigated using restricted cubic splines adjusted for sex, racial and ethnic background, tobacco use, Townsend Deprivation Index, alcohol consumption, educational attainment, employment status, self-reported health, diet quality, body mass index, medication use, physical activity, and handgrip strength.</p><p><strong>Results: </strong>The analytic sample comprised 74,191 participants (mean [SD] age, 55.2 [7.8] years; 57%women) who were followed-up for 7.9 years (IQR = 7.3-8.4). Overall, 3297 (4.3%) cases of incident LBD, 1224 (1.6%) cases of DD, and 792 (1.0%) of CD were documented. The association between age and LBD showed a curvilinear shape with significant higher risk within the range of 61 (hazard ratio [HR] = 1.39 [95%CI,1.02-1.49]) and 70 (HR = 1.71 [95%CI,1.38-2.12]) years (reference:40 years). Similarly, the association of age with DD exhibited a significant curvilinear association within the range of 60 (HR = 1.31 [95%CI,1.01-1.92]) and 70 (HR = 2.74 [95%CI,1.94-3.86]) years. The association between age and CD was not significant.</p><p><strong>Conclusions: </strong>The risk of LBD and DD, but not CD, increases beyond 60 years of age. Targeting people at this critical age-threshold to prevent risk for LBD and DD may be warranted for future interventions and preventive health programmes.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"861-868"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sacrum1-pubic angle: a novel and alternative morphologic radiological parameter for assessing spinopelvic sagittal alignment in human adults.","authors":"Feiyu Zu, Hao Qi, Chenchen Wang, Zenghui Zhao, Zhaoxuan Wang, Chenxi Wang, Wei Chen, Zhiyong Hou, Rui Xue, Di Zhang","doi":"10.1007/s00586-025-08681-8","DOIUrl":"10.1007/s00586-025-08681-8","url":null,"abstract":"<p><strong>Objective: </strong>Spinopelvic sagittal balance ensures efficient posture and minimizes energy expenditure by aligning the spine, pelvis, and lower extremities. Deviations can cause clinical issues like back pain and functional limitations. Key radiographic parameters, including pelvic tilt (PT), pelvic incidence (PI), sacral slope (SS), and lumbar lordosis (LL), are essential for evaluating spinal pathologies and planning surgeries. Accurate PI measurement is challenging in certain conditions, necessitating alternative parameters. This study aimed to introduce a new, easily measurable parameter and examine its reliability and correlation with established sagittal parameters.</p><p><strong>Methods: </strong>This study analyzed 107 asymptomatic adult volunteers (57 males and 50 females), with an average age of 36.75 years. Whole-spine radiographs in the standing position were taken using EOS technology. The established spinopelvic sagittal parameters and a novel parameter, sacrum1-pubic angle (S1PA), were measured. The correlation coefficient of each parameter, the regression equation of PI using S1PA, and the regression equation of PTα using PTβ were obtained. The intraclass correlation coefficients (ICCs) was calculated to evaluate the measurement reliability.</p><p><strong>Results: </strong>Morphologic (S1PA, PI) and positional parameters (PTα, PTβ, PTγ, SS, LL) showed no significant gender differences (p > 0.05). S1PA had strong correlations with PI (r = -0.883, p < 0.001) and other parameters. PTα demonstrated a strong correlation with PTβ (r = -0.929, p < 0.001). PI could be predicted according to the regression equation: PI = 71.672 - 4.537 × S1PA (R² = 0.779, p < 0.001). The PTα could be predicted using the following equation: PTα = 67.245 - 0.865 × PTβ (R² = 0.864, p < 0.001). Reliability analysis showed high intra- and inter-rater agreement in all the spinopelvic parameters.</p><p><strong>Conclusion: </strong>The S1PA is a dependable parameter for evaluating the morphology and orientation of the pelvis. PI could be precisely predicted using the S1PA. These insights are valuable for clinicians, enhancing their ability to assess spinopelvic sagittal alignment accurately.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"910-917"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the minimum clinically important difference (MCID) of the five-repetition sit-to-stand test in patients with lumbar disc herniation.","authors":"Anita M Klukowska, Manon G Dol, W Peter Vandertop, Marc L Schröder, Victor E Staartjes","doi":"10.1007/s00586-024-08582-2","DOIUrl":"10.1007/s00586-024-08582-2","url":null,"abstract":"<p><strong>Background: </strong>The impact of surgical interventions on lumbar disc herniation (LDH) is often assessed using objective functional impairment (OFI) tests like the five-repetition sit-to-stand (5R-STS) test. This study calculates the minimum clinically important difference (MCID) for 5R-STS improvement in patients with LDH one year after surgery.</p><p><strong>Methods: </strong>Adult patients with LDH scheduled for surgery were prospectively recruited from a Dutch short-stay spinal clinic. The 5R-STS time, Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), Numeric Rating Scale for back and leg pain, EQ-5D-3L health-related quality of life questionnaire and EQ5D-VAS were recorded preoperatively, at 6-weeks and 1-year post-operatively. The MCID was calculated using anchor-based methods (within-patient change; between-patient change; and receiver-operating characteristic approaches) and distribution-based methods (0.5 standard deviation (SD); effect size; standard error of measurement; standardized response mean; and 95% minimum detectable change (MDC)). The final MCID value was based on the \"gold standard\": an averaging of the anchor-based methods using ODI and RMDQ as the closest available anchors.</p><p><strong>Results: </strong>We prospectively recruited 134 patients. One-year follow-up was completed by 103 (76.8%) of patients. The MCID values derived using different methods varied from 0.7 to 5.1 s (s). The final, averaged, anchor-based MCID for improvement was 3.6 s. Within distribution-based methods, 95% MDC and 0.5SD approach, yielded an MCID of 3.0 and 3.8 s, respectively, aligning closely with the overall anchor-derived MCID for 5R-STS.</p><p><strong>Conclusion: </strong>In a patient with LDH, an improvement in 5R-STS performance of at least 3.6 s can be regarded as a clinically relevant improvement.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"1107-1114"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}