{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:58:16Z","timestamp":1786125496409,"version":"build-2736575974"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2020,6,10]],"date-time":"2020-06-10T00:00:00Z","timestamp":1591747200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurosurg.","NEUROS"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>The impact of symptom characteristics on outcomes of spine surgery remains elusive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To determine the impact of symptom location, severity, and duration on outcomes following lumbar spine surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      We queried the Quality Outcomes Database (QOD) for patients undergoing elective lumbar spine surgery for lumbar degenerative spine disease. Multivariable regression was utilized to determine the impact of preoperative symptom characteristics (location, severity, and duration) on improvement in disability, quality of life, return to work, and patient satisfaction at 1 yr. Relative predictor importance was determined using an importance metric defined as Wald \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      penalized by degrees of freedom.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      A total of 22 022 subjects were analyzed. On adjusted analysis, we found patients with predominant leg pain were more likely to be satisfied (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a0.0001), achieve minimum clinically important difference (MCID) in Oswestry Disability Index (ODI) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.002), and return to work (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.03) at 1 yr following surgery without significant difference in Euro-QoL-5D (EQ-5D) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.09) [ref\u00a0=\u00a0predominant back pain]. Patients with equal leg and back pain were more likely to be satisfied (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a0.0001), but showed no significant difference in achieving MCID (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.22) or return to work (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.07). Baseline numeric rating scale-leg pain and symptom duration were most important predictors of achieving MCID and change in EQ-5D. Predominant symptom was not found to be an important determinant of return to work. Worker's compensation was found to be most important determinant of satisfaction and return to work.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Predominant symptom location is a significant determinant of functional outcomes following spine surgery. However, pain severity and duration have higher predictive importance. Return to work is more dependent on sociodemographic features as compared to symptom characteristics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuros\/nyaa240","type":"journal-article","created":{"date-parts":[[2020,5,21]],"date-time":"2020-05-21T15:18:55Z","timestamp":1590074335000},"page":"1037-1045","source":"Crossref","is-referenced-by-count":12,"title":["Impact of Dominant Symptom on 12-Month Patient-Reported Outcomes for Patients Undergoing Lumbar Spine Surgery"],"prefix":"10.1227","volume":"87","author":[{"given":"Clinton J","family":"Devin","sequence":"first","affiliation":[{"name":"Steamboat Orthopaedic and Spine Institute, Steamboat Springs, Colorado"},{"name":"Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony L","family":"Asher","sequence":"additional","affiliation":[{"name":"Neuroscience Institute, Carolina Neurosurgery & Spine Associates, Carolinas Healthcare System, Charlotte, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin R","family":"Archer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Vanderbilt Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anshit","family":"Goyal","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inamullah","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Kerezoudis","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Ali","family":"Alvi","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacquelyn S","family":"Pennings","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Vanderbilt Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernes","family":"Karacay","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher I","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery, Duke University, Durham, North Carolina"},{"name":"Departments of Orthopedic Surgery, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica F","family":"Bisson","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J","family":"Knightly","sequence":"additional","affiliation":[{"name":"Atlantic Neurosurgical Specialists, Morristown, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen V","family":"Mummaneni","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin T","family":"Foley","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0543-396X","authenticated-orcid":false,"given":"Mohamad","family":"Bydon","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,11]]},"reference":[{"issue":"Suppl 2","key":"bib1-20231011","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/ner.12018","article-title":"Epidemiology of low back pain in adults","volume":"17","author":"Manchikanti","year":"2014","journal-title":"Neuromodulation"},{"issue":"4","key":"bib2-20231011","doi-asserted-by":"crossref","first-page":"389","DOI":"10.2105\/AJPH.73.4.389","article-title":"Characteristics of physician visits for back symptoms: a national perspective","volume":"73","author":"Cypress","year":"1983","journal-title":"Am J Public Health"},{"issue":"3","key":"bib3-20231011","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1179\/jmt.1996.4.3.99","article-title":"Acute low back problems in adults, AHCPR guideline no. 14","volume":"4","author":"Bigos","year":"1996","journal-title":"J Man Manip Ther"},{"issue":"12","key":"bib4-20231011","first-page":"1571","article-title":"Prevalence of disabilities and associated health conditions among adults\u2013United States, 1999","volume":"285","year":"2001","journal-title":"JAMA"},{"issue":"6","key":"bib5-20231011","doi-asserted-by":"crossref","first-page":"1630","DOI":"10.3171\/2017.7.JNS17991","article-title":"The impact of spine disease, relative to cranial disease, on perception of health and care experience: an analysis of 1484 patients in a tertiary center","volume":"129","author":"Kerezoudis","year":"2018","journal-title":"J Neurosurg"},{"issue":"13","key":"bib6-20231011","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1001\/jama.2010.338","article-title":"Trends, major medical complications, and charges associated with surgery for lumbar spinal stenosis in older adults","volume":"303","author":"Deyo","year":"2010","journal-title":"JAMA"},{"issue":"2","key":"bib7-20231011","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1227\/01.NEU.0000255522.42579.EA","article-title":"Spinal cord stimulation versus reoperation for failed back surgery syndrome: a cost effectiveness and cost utility analysis based on a randomized, controlled trial","volume":"61","author":"North","year":"2007","journal-title":"Neurosurgery"},{"issue":"4","key":"bib8-20231011","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.amjmed.2008.01.004","article-title":"Management of back pain in patients with previous back surgery","volume":"121","author":"Ragab","year":"2008","journal-title":"Am J Med"},{"issue":"2","key":"bib9-20231011","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1111\/j.1526-4637.2006.00112.x","article-title":"Low back pain in older adults: are we utilizing healthcare resources wisely","volume":"7","author":"Weiner","year":"2006","journal-title":"Pain Med"},{"issue":"4","key":"bib10-20231011","doi-asserted-by":"crossref","first-page":"357","DOI":"10.3171\/2016.11.SPINE16526","article-title":"An analysis from the Quality Outcomes Database, part 1. Disability, quality of life, and pain outcomes following lumbar spine surgery: predicting likely individual patient outcomes for shared decision-making","volume":"27","author":"McGirt","year":"2017","journal-title":"J Neurosurg Spine"},{"issue":"2","key":"bib11-20231011","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1007\/s00586-015-4078-8","article-title":"Predictors of improvement in quality of life and pain relief in lumbar spinal stenosis relative to patient age: a study based on the spine tango registry","volume":"26","author":"Sobottke","year":"2017","journal-title":"Eur Spine J"},{"issue":"13","key":"bib12-20231011","first-page":"223","article-title":"Acute lumbar back pain","volume":"113","author":"Casser","year":"2016","journal-title":"Dtsch Arztebl Int"},{"issue":"12","key":"bib13-20231011","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.1016\/j.spinee.2017.05.027","article-title":"Effect of patients\u2019 functional status on satisfaction with outcomes 12 months after elective spine surgery for lumbar degenerative disease","volume":"17","author":"Chotai","year":"2017","journal-title":"Spine J"},{"issue":"22 Suppl 1","key":"bib14-20231011","doi-asserted-by":"crossref","first-page":"S106","DOI":"10.1097\/BRS.0000000000000579","article-title":"The National Neurosurgery Quality and Outcomes Database (N2QOD): a collaborative North American outcomes registry to advance value-based spine care","volume":"39","author":"Asher","year":"2014","journal-title":"Spine"},{"issue":"1","key":"bib15-20231011","doi-asserted-by":"crossref","first-page":"E6","DOI":"10.3171\/2012.10.FOCUS12297","article-title":"The National Neurosurgery Quality and Outcomes Database (N2QOD): general overview and pilot-year project description","volume":"34","author":"McGirt","year":"2013","journal-title":"Neurosurg Focus"},{"issue":"22","key":"bib16-20231011","doi-asserted-by":"crossref","first-page":"2940","DOI":"10.1097\/00007632-200011150-00017","article-title":"The Oswestry Disability Index","volume":"25","author":"Fairbank","year":"2000","journal-title":"Spine"},{"issue":"3","key":"bib17-20231011","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/0168-8510(90)90421-9","article-title":"EuroQol\u2013a new facility for the measurement of health-related quality of life","volume":"16","year":"1990","journal-title":"Health Policy"},{"issue":"6","key":"bib18-20231011","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1097\/00007632-199603150-00017","article-title":"The North American Spine Society lumbar spine outcome assessment instrument: reliability and validity tests","volume":"21","author":"Daltroy","year":"1996","journal-title":"Spine"},{"issue":"6","key":"bib19-20231011","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1016\/j.spinee.2007.11.006","article-title":"Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study Questionnaire Short Form 36, and pain scales","volume":"8","author":"Copay","year":"2008","journal-title":"Spine J"},{"key":"bib20-20231011","author":"Harrell","year":"2017","journal-title":"Package \u201cRms"},{"issue":"4","key":"bib21-20231011","doi-asserted-by":"crossref","first-page":"370","DOI":"10.3171\/2016.8.SPINE16527","article-title":"An analysis from the Quality Outcomes Database, part 2. Predictive model for return to work after elective surgery for lumbar degenerative disease","volume":"27","author":"Asher","year":"2017","journal-title":"J Neurosurg Spine"},{"issue":"6","key":"bib22-20231011","doi-asserted-by":"crossref","first-page":"E13","DOI":"10.3171\/2015.8.FOCUS15338","article-title":"Prediction model for outcome after low-back surgery: individualized likelihood of complication, hospital readmission, return to work, and 12-month improvement in functional disability","volume":"39","author":"McGirt","year":"2015","journal-title":"Neurosurg Focus"},{"issue":"5","key":"bib23-20231011","doi-asserted-by":"crossref","first-page":"E9","DOI":"10.3171\/2018.8.FOCUS18326","article-title":"A predictive model and nomogram for predicting return to work at 3 months after cervical spine surgery: an analysis from the Quality Outcomes Database","volume":"45","author":"Devin","year":"2018","journal-title":"Neurosurg Focus"},{"issue":"12","key":"bib24-20231011","doi-asserted-by":"crossref","first-page":"870","DOI":"10.2176\/nmc.oa2012-0415","article-title":"Decompression only versus fusion surgery for lumbar stenosis in elderly patients over 75 years old: which is reasonable","volume":"53","author":"Lee","year":"2013","journal-title":"Neurol Med Chir"},{"issue":"17","key":"bib25-20231011","doi-asserted-by":"crossref","first-page":"2030","DOI":"10.1097\/01.BRS.0000083325.27357.39","article-title":"Impact of neck and arm pain on overall health status","volume":"28","author":"Daffner","year":"2003","journal-title":"Spine"},{"issue":"5","key":"bib26-20231011","doi-asserted-by":"crossref","first-page":"629","DOI":"10.14444\/5078","article-title":"Arm pain versus neck pain: a novel ratio as a predictor of post-operative clinical outcomes in cervical radiculopathy patients","volume":"12","author":"Passias","year":"2018","journal-title":"Int J Spine Surg"}],"container-title":["Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/neurosurgery\/article-pdf\/87\/5\/1037\/33880620\/nyaa240.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/10.1093\/neuros\/nyaa240","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:56:33Z","timestamp":1786121793000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1093\/neuros\/nyaa240"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,10]]},"references-count":26,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1093\/neuros\/nyaa240","relation":{},"ISSN":["0148-396X","1524-4040"],"issn-type":[{"value":"0148-396X","type":"print"},{"value":"1524-4040","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,10]]}}}