{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T23:40:45Z","timestamp":1783035645808,"version":"3.54.6"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T00:00:00Z","timestamp":1665014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>High-impact chronic pain (HICP) is a term that characterizes the presence of a severe and troubling pain-related condition. To date, the prevalence of HICP in lumbar spine surgery recipients and their HICP transitions from before to after surgery are unexplored. The purpose was to define HICP prevalence, transition types, and outcomes in lumbar spine surgery recipients and to identify predictors of HICP outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In total, 43,536 lumbar surgery recipients were evaluated for HICP transition. Lumbar spine surgery recipients were categorized as having HICP preoperatively and at 3\u2009months after surgery if they exhibited chronic and severe pain and at least one major activity limitation. Four HICP transition groups (Stable Low Pain, Transition from HICP, Transition to HICP, and Stable High Pain) were categorized and evaluated for outcomes. Multivariate multinomial modeling was used to predict HICP transition categorization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this sample, 15.1% of individuals exhibited HICP preoperatively; this value declined to 5.1% at 3\u2009months after surgery. Those with HICP at baseline and 3\u2009months had more comorbidities and worse overall outcomes. Biological, psychological, and social factors predicted HICP transition or Stable High Pain; some of the strongest involved social factors of 2 or more to transition to HICP (OR\u2009=\u20091.43; 95% CI\u2009=\u20091.21\u20131.68), and baseline report of pain\/disability (OR\u2009=\u20093.84; 95% CI\u2009=\u20093.20\u20134.61) and psychological comorbidity (OR\u2009=\u20091.78; 95% CI\u2009=\u20091.48\u20132.12) to Stable Stable High Pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The percentage of individuals with HICP preoperatively (15.1%) was low, which further diminished over a 3-month period (5.1%). Postoperative HICP groups had higher levels of comorbidities and worse baseline outcomes scores. Transition to and maintenance of HICP status was predicted by biological, psychological, and social factors.<\/jats:p><\/jats:sec>","DOI":"10.1093\/pm\/pnac150","type":"journal-article","created":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T13:49:40Z","timestamp":1665064180000},"page":"258-268","source":"Crossref","is-referenced-by-count":12,"title":["High-Impact Chronic Pain Transition in Lumbar Surgery Recipients"],"prefix":"10.1093","volume":"24","author":[{"given":"Chad E","family":"Cook","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Duke University , Durham, North Carolina"},{"name":"Duke Clinical Research Institute, Duke University , Durham, North Carolina"},{"name":"Department of Population Health Sciences, Duke University , Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4988-9421","authenticated-orcid":false,"given":"Steven Z","family":"George","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Duke University , Durham, North Carolina"},{"name":"Duke Clinical Research Institute, Duke University , Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4286-0733","authenticated-orcid":false,"given":"Trevor","family":"Lentz","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Duke University , Durham, North Carolina"},{"name":"Duke Clinical Research Institute, Duke University , Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0066-366X","authenticated-orcid":false,"given":"Christine","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, , Durham, North Carolina, USA"},{"name":"Duke University , Durham, North Carolina, 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oren N","family":"Gottfried","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, , Durham, North Carolina, USA"},{"name":"Duke University , Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,10,6]]},"reference":[{"issue":"1","key":"2023030119152823200_","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/j.pain.0000000000001384","article-title":"Chronic pain as a symptom or a disease: The IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11)","volume":"160","author":"Treede","year":"2019","journal-title":"Pain"},{"issue":"2","key":"2023030119152823200_","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.jpain.2018.07.006","article-title":"Prevalence and profile of high-impact chronic pain in the United 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