{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:51:54Z","timestamp":1791345114179,"version":"4.3.1"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":89,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Musculoskelet Disord"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Different patient-reported outcome measures (PROMs) may classify the same patient differently as a treatment responder after lumbar decompressive surgery. We aimed to quantify inter-instrument agreement on minimal clinically important difference (MCID)-based responder status at one month postoperatively, characterize multi-dimensional response discordance, and identify independent one-month PROM predictors of one-month patient dissatisfaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this prospective observational cohort study, 158 consecutive adults undergoing lumbar decompressive surgery for disc herniation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200977) or spinal stenosis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200981) at a single neurosurgical centre were enrolled; all underwent single-level decompression of the symptomatic level. Of these, 134 (84.8%) completed paired baseline and one-month assessments using the Visual Analogue Scale for leg pain (VAS), Oswestry Disability Index (ODI), and EQ-5D-5\u00a0L utility index. MCID thresholds were derived from external sources (VAS\u2009\u2265\u20091.5 points, ODI\u2009\u2265\u200910 points, EQ-5D-5\u00a0L\u2009\u2265\u20090.10). Inter-instrument agreement was quantified using Cohen\u2019s kappa (\u03ba). Patient dissatisfaction was defined by the satisfaction subscale of the Swiss Spinal Stenosis Questionnaire (SSSQ\u2009&gt;\u200912). Independent predictors of dissatisfaction were identified by multivariable linear regression with bootstrapped confidence intervals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All instruments showed significant improvement at one month (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). MCID-based responder rates differed markedly: VAS 82.1%, EQ-5D-5\u00a0L 83.6%, and ODI 54.5%. Inter-instrument agreement was slight to fair (\u03ba\u2009=\u20090.19\u20130.29); Only 47.0% of patients achieved MCID across all three instruments simultaneously, while 94.0% achieved it on at least one \u2014 producing a 47-percentage-point disagreement zone. A total of 39.6% (53\/134) of patients experienced VAS and\/or EQ-5D-5\u00a0L improvement without corresponding ODI improvement. 23% (31\/134) of patients were dissatisfied at one month. In multivariable regression adjusted for age, sex, and diagnosis (R\u00b2 = 0.40), one-month EQ-5D-5\u00a0L items of mobility limitation and anxiety\/depression, together with residual functional disability (ODI total), independently predicted dissatisfaction; residual pain did not.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Instrument selection alone changes responder classification rates by nearly 30% points at one month after lumbar decompressive surgery. Dissatisfaction is driven by residual functional limitation and psychological distress, not residual pain. Multi-dimensional PROM assessment with diagnosis-informed instrument selection may help identify, at the early postoperative visit, patients requiring targeted rehabilitation and psychological support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12891-026-10195-3","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T09:57:48Z","timestamp":1783677468000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Is pain relief enough? Early response discordance after lumbar decompressive surgery: a prospective cohort study"],"prefix":"10.1186","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4047-9922","authenticated-orcid":false,"given":"Tomasz","family":"Szczepa\u0144ski","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8286-7606","authenticated-orcid":false,"given":"Marta","family":"Ko\u017aba-Goszty\u0142a","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0791-8425","authenticated-orcid":false,"given":"Anastasija","family":"Krzemi\u0144ska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6781-7013","authenticated-orcid":false,"given":"Grzegorz","family":"Mi\u0119kisiak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9819-2455","authenticated-orcid":false,"given":"Bogdan","family":"Czapiga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"10195_CR1","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1097\/BRS.0b013e31815e3a10","volume":"33","author":"RWJG Ostelo","year":"2008","unstructured":"Ostelo RWJG, Deyo RA, Stratford P, et al. 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The study was conducted in accordance with the principles of the Declaration of Helsinki and its subsequent amendments. All participants were informed of the study objectives and methods, and provided written informed consent prior to enrolment. Participants were informed of their right to withdraw from the study at any time without consequences for their medical care.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. This manuscript does not contain any individual person\u2019s data in any form that would allow identification of study participants. All data were fully anonymised prior to analysis.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"837"}}