{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T18:20:27Z","timestamp":1778523627027,"version":"3.51.4"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>This study aimed to 1) describe the 2-year postoperative trajectories of leg pain and overall clinical outcome after surgery for radiculopathy, 2) identify the preoperative prognostic factors that predict trajectories representing poor clinical outcomes, and 3) develop and internally validate multivariable prognostic models to assist with clinical decision-making.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>This retrospective cohort study included patients enrolled in the Canadian Spine Outcomes and Research Network who were diagnosed with lumbar disc pathology and radiculopathy and had undergone lumbar discectomy at one of 18 spine centers. Potential outcome predictors included preoperative demographic, health-related, and clinical prognostic factors. Clinical outcomes were 1) 2-year univariable latent trajectories of leg pain intensity (numeric pain rating scale) and 2) overall outcomes comprising multivariable trajectories showing the combined postoperative courses of leg and back pain intensity (numeric pain rating scale) together with pain-related disability (Oswestry Disability Index). Each outcome model identified a subgroup of patients classified as experiencing a poor outcome based on minimal change in their clinical status after surgery. Multivariable risk model performance and internal validity were evaluated with discrimination and calibration statistics based on bootstrap shrinkage with 500 resamplings.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The authors included data from 1142 patients (47.6% female). The trajectory models identified 3 subgroups based on the patients\u2019 postoperative courses of pain or disability: 88.6% of patients in the leg pain model and 71.9% in the overall outcome model experienced a good-to-excellent outcome. The models classified 11.4% (leg pain outcome) and 28.2% (overall outcome) of patients as experiencing a poor clinical outcome, which was defined as minimal improvement in pain or disability after surgery. Eleven individual demographic, health, and clinical factors predicted patients\u2019 poor leg pain and overall outcomes. The performance of the multivariable risk model for leg pain was inadequate, while the overall outcome model had acceptable discrimination, calibration, and internal validity for predicting a poor surgical outcome.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Patients with lumbar radiculopathy experience heterogeneous postoperative trajectories of pain and disability after lumbar discectomy. Individual preoperative factors are associated with postoperative outcomes and can be combined within a multivariable risk model to predict overall patient outcome. These results may inform clinical practice but require external validation before confident clinical implementation.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.6.spine24430","type":"journal-article","created":{"date-parts":[[2024,10,5]],"date-time":"2024-10-05T01:59:02Z","timestamp":1728093542000},"page":"1-10","source":"Crossref","is-referenced-by-count":2,"title":["Outcome prediction following lumbar disc surgery: a longitudinal study of outcome trajectories, prognostic factors, and risk models"],"prefix":"10.3171","author":[{"given":"Jeffrey J.","family":"H\u00e9bert","sequence":"first","affiliation":[{"name":"Faculty of Kinesiology, University of New Brunswick, Fredericton, New Brunswick, Canada;"},{"name":"School of Allied Health, Murdoch University, Murdoch, Western Australia, Australia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin E.","family":"Bigney","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology, University of New Brunswick, Fredericton, New Brunswick, Canada;"},{"name":"Canada East Spine Centre, Saint John, New Brunswick, Canada;"},{"name":"Horizon Health Network, Saint John, New Brunswick, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Nowell","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology, University of New Brunswick, Fredericton, New Brunswick, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuaijin","family":"Wang","sequence":"additional","affiliation":[{"name":"Canada East Spine Centre, Saint John, New Brunswick, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niels","family":"Wedderkopp","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark;"},{"name":"The Spine Center of Southern Denmark, Region of Southern Denmark, Middelfart, Denmark;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Small","sequence":"additional","affiliation":[{"name":"Canada East Spine Centre, Saint John, New Brunswick, Canada;"},{"name":"Horizon Health Network, Saint John, New Brunswick, Canada;"},{"name":"Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward P.","family":"Abraham","sequence":"additional","affiliation":[{"name":"Canada East Spine Centre, Saint John, New Brunswick, Canada;"},{"name":"Horizon Health Network, Saint John, New Brunswick, Canada;"},{"name":"Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Najmedden","family":"Attabib","sequence":"additional","affiliation":[{"name":"Canada East Spine Centre, Saint John, New Brunswick, Canada;"},{"name":"Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada;"},{"name":"Division of Neurosurgery, Zone 2, Horizon Health Network, Canada East Spine Centre, Saint John, New Brunswick, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan","family":"Evaniew","sequence":"additional","affiliation":[{"name":"University of Calgary Spine Program, University of Calgary, Calgary, Alberta, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00e9r\u00f4me","family":"Paquet","sequence":"additional","affiliation":[{"name":"Centre de Recherche CHU de Quebec, CHU de Quebec-Universite Laval, Qu\u00e9bec City, Qu\u00e9bec, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raphaele","family":"Charest-Morin","sequence":"additional","affiliation":[{"name":"Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopedics Surgery, University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Supriya","family":"Singh","sequence":"additional","affiliation":[{"name":"London Health Science Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, London, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael H.","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Orthopaedics, Montreal General Hospital, McGill University, Montreal, Qu\u00e9bec, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrienne","family":"Kelly","sequence":"additional","affiliation":[{"name":"Sault Area Hospital, Northern Ontario School of Medicine, Sault Ste. Marie, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Kingwell","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, University of Ottawa, Ottawa Hospital, Ottawa, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Crawford","sequence":"additional","affiliation":[{"name":"Department of Surgery, Spine Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Nataraj","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Travis","family":"Marion","sequence":"additional","affiliation":[{"name":"Department of Surgery, Thunder Bay Regional Health Science Centre, Thunder Bay, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"LaRue","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Chirurgie, Facult\u00e9 de M\u00e9decine et des Sciences de la Sant\u00e9, Universit\u00e9 de Sherbrooke, Sherbrooke, Qu\u00e9bec, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry","family":"Ahn","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, St. Michael\u2019s Hospital, Toronto, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamilton","family":"Hall","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Toronto, Toronto, Ontario, Canada; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles G.","family":"Fisher","sequence":"additional","affiliation":[{"name":"Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopedics Surgery, University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y. Raja","family":"Rampersaud","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Orthopaedic Surgery, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Dea","sequence":"additional","affiliation":[{"name":"Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopedics Surgery, University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher S.","family":"Bailey","sequence":"additional","affiliation":[{"name":"London Health Science Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, London, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil A.","family":"Manson","sequence":"additional","affiliation":[{"name":"Canada East Spine Centre, Saint John, New Brunswick, Canada;"},{"name":"Horizon Health Network, Saint John, New Brunswick, Canada;"},{"name":"Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"Lancet Rheumatol","first-page":"e316","article-title":"Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021","volume":"5","year":"2023","unstructured":"GBD 2021 Low Back Pain Collaborators. 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