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Article ; Online: Response to letter to the editor regarding "Predictors for failure after surgery for lumbar spinal stenosis: a prospective observational study".

Alhaug, Ole Kristian / Dolatowski, Filip C / Lønne, Greger

The spine journal : official journal of the North American Spine Society

2023 Volume 23, Issue 12, Page(s) 1944

MeSH term(s)	Humans ; Spinal Stenosis/surgery ; Treatment Outcome ; Prospective Studies
Language	English
Publishing date	2023-11-10
Publishing country	United States
Document type	Observational Study ; Letter
ZDB-ID	2037072-6
ISSN	1878-1632 ; 1529-9430
ISSN (online)	1878-1632
ISSN	1529-9430
DOI	10.1016/j.spinee.2023.08.022
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Article ; Online: Postoperative complications after surgery for lumbar spinal stenosis, assessment using two different data sources.

Alhaug, Ole Kristian / Dolatowski, Filip C / Kaur, Simran / Lønne, Greger

Acta neurochirurgica

2024 Volume 166, Issue 1, Page(s) 189

Abstract: Purpose: Lumbar spinal stenosis (LSS) is a prevalent disorder, and surgery for LSS is a common procedure. Postoperative complications occur after any surgery and impose costs for society and costs and additional morbidity for patients. Since ... ...

Abstract	Purpose: Lumbar spinal stenosis (LSS) is a prevalent disorder, and surgery for LSS is a common procedure. Postoperative complications occur after any surgery and impose costs for society and costs and additional morbidity for patients. Since complications are relatively rare, medical registries of large populations may provide valuable knowledge. However, recording of complications in registries can be incomplete. To better estimate the true prevalence of complications after LSS surgery, we reviewed two different sources of data and recorded complications for a sample of Norwegian LSS patients. Methods: 474 patients treated surgically for LSS during 2015 and 2016 at four hospitals reported to a national spine registry (NORspine). Postoperative complications were recorded by patients in NORspine, and we cross-referenced complications documented in NORspine with the patients´ electronic patient records (EPR) to re-test the complication rates. We performed descriptive statistics of complication rates using the two different data sources above, and analyzed the association between postoperative complications and clinical outcome with logistic regression. Results: The mean (95%CI) patient age was 66.3 (65.3-67.2) years, and 254 (53.6%) were females. All patients were treated with decompression, and 51 (10.7%) received an additional fusion during the index surgery. Combining the two data sources, we found a total rate for postoperative complications of 22.4%, the NORspine registry reported a complication rate of 15.6%, and the EPR review resulted in a complication rate of 16.0%. However, the types of complications were inconsistent across the two data sources. According to NORspine, the frequency of reoperation within 90 days was 0.9% and according to EPR 3.4%. The rates of wound infection were for NORspine 3.1% and EPR review 2.1%. There was no association between postoperative complication and patient reported outcome. Conclusion: Postoperative complications occurred in 22% of LSS patients. The frequency of different postoperative complications differed between the two data sources.
MeSH term(s)	Humans ; Spinal Stenosis/surgery ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Female ; Male ; Aged ; Lumbar Vertebrae/surgery ; Registries ; Decompression, Surgical/adverse effects ; Decompression, Surgical/methods ; Spinal Fusion/adverse effects ; Spinal Fusion/methods ; Norway/epidemiology ; Middle Aged ; Information Sources
Language	English
Publishing date	2024-04-23
Publishing country	Austria
Document type	Journal Article
ZDB-ID	80010-7
ISSN	0942-0940 ; 0001-6268
ISSN (online)	0942-0940
ISSN	0001-6268
DOI	10.1007/s00701-024-06086-y
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Article ; Online: Characteristics and outcomes of patients who did not respond to a national spine surgery registry.

Kaur, Simran / Alhaug, Ole Kristian / Dolatowski, Filip C / Solberg, Tore K / Lønne, Greger

BMC musculoskeletal disorders

2023 Volume 24, Issue 1, Page(s) 164

Abstract: Background: Loss to follow-up may bias outcome assessments in medical registries. This cohort study aimed to analyze and compare patients who failed to respond with those that responded to the Norwegian Registry for Spine Surgery (NORspine).: Methods!# ...

Abstract	Background: Loss to follow-up may bias outcome assessments in medical registries. This cohort study aimed to analyze and compare patients who failed to respond with those that responded to the Norwegian Registry for Spine Surgery (NORspine). Methods: We analyzed a cohort of 474 consecutive patients operated for lumbar spinal stenosis at four public hospitals in Norway during a two-year period. These patients reported sociodemographic data, preoperative symptoms, and Oswestry Disability Index (ODI), numerical rating scales (NRS) for back and leg pain to NORspine at baseline and 12 months postoperatively. We contacted all patients who did not respond to NORspine after 12 months. Those who responded were termed responsive non-respondents and compared to 12 months respondents. Results: One hundred forty (30%) did not respond to NORspine 12 months after surgery and 123 were available for additional follow-up. Sixty-four of the 123 non-respondents (52%) responded to a cross-sectional survey done at a median of 50 (36-64) months after surgery. At baseline, non-respondents were younger 63 (SD 11.7) vs. 68 (SD 9.9) years (mean difference (95% CI) 4.7 years (2.6 to 6.7); p = < 0.001) and more frequently smokers 41 (30%) vs. 70 (21%) RR (95%CI) = 1.40 (1.01 to 1.95); p = 0.044. There were no other relevant differences in other sociodemographic variables or preoperative symptoms. We found no differences in the effect of surgery on non-respondents vs. respondents (ODI (SD) = 28.2 (19.9) vs. 25.2 (18.9), MD (95%CI) = 3.0 ( -2.1 to 8.1); p = 0.250). Conclusion: We found that 30% of patients did not respond to NORspine at 12 months after spine surgery. Non-respondents were somewhat younger and smoked more frequently than respondents; however, there were no differences in patient-reported outcome measures. Our findings suggest that attrition bias in NORspine was random and due to non-modifiable factors.
MeSH term(s)	Humans ; Cohort Studies ; Cross-Sectional Studies ; Norway ; Outcome Assessment, Health Care ; Registries
Language	English
Publishing date	2023-03-04
Publishing country	England
Document type	Journal Article
ZDB-ID	2041355-5
ISSN	1471-2474 ; 1471-2474
ISSN (online)	1471-2474
ISSN	1471-2474
DOI	10.1186/s12891-023-06267-3
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Article ; Online: Predictors for failure after surgery for lumbar spinal stenosis: a prospective observational study.

Alhaug, Ole Kristian / Dolatowski, Filip C / Solberg, Tore K / Lønne, Greger

The spine journal : official journal of the North American Spine Society

2022 Volume 23, Issue 2, Page(s) 261–270

Abstract: Background/context: Some patients do not improve after surgery for lumbar spinal stenosis (LSS), and surgical treatment implies a risk for complications and deterioration. Patient selection is of paramount importance to improve the overall clinical ... ...

Abstract	Background/context: Some patients do not improve after surgery for lumbar spinal stenosis (LSS), and surgical treatment implies a risk for complications and deterioration. Patient selection is of paramount importance to improve the overall clinical results and identifying predictive factors for failure is central in this work. Purpose: We aimed to explore predictive factors for failure and worsening after surgery for LSS. Study design /setting: Retrospective observational study on prospectively collected data from a national spine registry with a 12-month follow-up. Patient sample: We analyzed 11,873 patients operated for LSS between 2007 and 2017 in Norway, included in the Norwegian registry for spine surgery (NORspine). Twelve months after surgery, 8919 (75.1%) had responded. Outcome measures: Oswestry Disability Index (ODI) 12 months after surgery. Methods: Predictors were assessed with uni- and multivariate logistic regression, using backward conditional stepwise selection and a significance level of 0.01. Failure (ODI>31) and worsening (ODI>39) were used as dependent variables. Results: Mean (95%CI) age was 66.6 (66.4-66.9) years, and 52.1% were females. The mean (95%CI) preoperative ODI score was 39.8 (39.4-40.1). All patients had decompression, and 1494 (12.6%) had an additional fusion procedure. Twelve months after surgery, the mean (95%CI) ODI score was 23.9 (23.5-24.2), and 2950 patients (33.2%) were classified as failures and 1921 (21.6%) as worse. The strongest predictors for failure were duration of back pain > 12 months (OR [95%CI]=2.24 [1.93-2.60]; p<.001), former spinal surgery (OR [95%CI]=2.21 [1.94-2.52]; p<.001) and age>70 years (OR (95%CI)=1.97 (1.69-2.30); p<.001). Socioeconomic variables increased the odds of failure (ORs between 1.36 and 1.62). The strongest predictors for worsening were former spinal surgery (OR [95%CI]=2.04 [1.77-2.36]; p<.001), duration of back pain >12 months (OR [95%CI]=1.83 [1.45-2.32]; p<.001) and age >70 years (OR [95%CI]=1.79 [1.49-2.14]; p<.001). Socioeconomic variables increased the odds of worsening (ORs between 1.33-1.67). Conclusions: After surgery for LSS, 33% of the patients reported failure, and 22% reported worsening as assessed by ODI. Preoperative duration of back pain for longer than 12 months, former spinal surgery, and age above 70 years were the strongest predictors for increased odds of failure and worsening after surgery.
MeSH term(s)	Female ; Humans ; Aged ; Male ; Spinal Stenosis/surgery ; Treatment Outcome ; Pain Measurement ; Lumbar Vertebrae/surgery ; Back Pain/surgery ; Decompression, Surgical/adverse effects
Language	English
Publishing date	2022-11-05
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	2037072-6
ISSN	1878-1632 ; 1529-9430
ISSN (online)	1878-1632
ISSN	1529-9430
DOI	10.1016/j.spinee.2022.10.010
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Article ; Online: Acute Paraspinal Compartment Syndrome After Deadlifting: A Case Report.

Cetinkaya, Abdullah / Grundnes, Oliver / Dolatowski, Filip C

JBJS case connector

2020 Volume 10, Issue 2, Page(s) e0279

Abstract: Case: A 27-year-old African man was admitted with acute right-sided loin pain that had started 4 hours after deadlifting. Renal colic was suspected, but clinical and radiological examination revealed no pathology of the urinary system. Further ... ...

Abstract	Case: A 27-year-old African man was admitted with acute right-sided loin pain that had started 4 hours after deadlifting. Renal colic was suspected, but clinical and radiological examination revealed no pathology of the urinary system. Further investigation revealed rhabdomyolysis. The back pain worsened with flexion, and both loins were hard on palpation 24 hours later. High intracompartmental pressures confirmed acute paraspinal compartment syndrome. Conclusions: We performed fasciotomy of the back muscles 28 hours after the onset of pain. Eighteen months after surgery, the patient no longer performed deadlifts but returned to pain-free exercise.
MeSH term(s)	Adult ; Compartment Syndromes/diagnosis ; Compartment Syndromes/surgery ; Diagnostic Errors ; Fasciotomy ; Humans ; Low Back Pain/etiology ; Male ; Pain, Intractable/etiology ; Paraspinal Muscles/surgery ; Weight Lifting/injuries
Language	English
Publishing date	2020-07-07
Publishing country	United States
Document type	Case Reports ; Journal Article
ISSN	2160-3251
ISSN (online)	2160-3251
DOI	10.2106/JBJS.CC.19.00279
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Article ; Online: Criteria for failure and worsening after surgery for lumbar spinal stenosis: a prospective national spine registry observational study.

Alhaug, Ole Kristian / Dolatowski, Filip C / Solberg, Tore K / Lønne, Greger

The spine journal : official journal of the North American Spine Society

2021 Volume 21, Issue 9, Page(s) 1489–1496

Abstract: Background context: Criteria for success after surgical treatment of lumbar spinal stenosis (LSS) have been defined previously; however, there are no clear criteria for failure and worsening after surgery as assessed by patient-reported outcome measures ...

Abstract	Background context: Criteria for success after surgical treatment of lumbar spinal stenosis (LSS) have been defined previously; however, there are no clear criteria for failure and worsening after surgery as assessed by patient-reported outcome measures (PROMs). Purpose: We aimed to quantify changes in standard PROMs that most accurately identified failure and worsening after surgery for LSS. Study design /setting: Retrospective analysis of prospective national spine registry data with 12-months follow-up. Patient sample: We analyzed 10,822 patients aged 50 years and older operated in Norway during a decade, and 8,258 (76%) responded 12 months after surgery. Outcome measures (proms): We calculated final scores, absolute changes, and percentage changes for Oswestry Disability Index (ODI), Numeric Rating Scale (NRS) for back and leg pain (0-10), and EuroQol-5D (EQ-5D). These 12 PROM derivates were compared to the Global Perceived Effect (GPE), a 7-point Likert scale. Methods: We used ODI, NRS back and leg pain, and EQ-5D 12 months after surgery to identify patients with failure (no effect) and worsening (clinical deterioration). The corresponding GPE at 12-months was graded as failure (GPE=4-7) and worsening (GPE=6-7) and used as an external criterion. To quantify the most accurate cut-off values corresponding to failure and worsening, we calculated areas under the curves (AUCs) of receiver operating characteristics (ROC) curves for the respective PROM derivates. Results: Mean (95% CI) age was 68.3 (68.1 - 68.5) years, and 52% were females. There were 1,683 (20%) failures, and 476 (6%) patients were worse after surgery. The mean (95% CI) pre- and postoperative ODIs were 39.8 (39.5 - 40.2) and 23.7 (23.3 - 24.1), respectively. At 12 months, the mean difference (95% CI) in ODI was 16.1 (15.7 - 16.4), and the mean (95% CI) percentage improvement 38.8% (37.8 - 38.8). The PROM derivates identified failure and worsening accurately (AUC>0.80), except for the absolute change in EQ-5D. The ODI derivates were most accurate to identify both failure and worsening. We found that less than 20% improvement in ODI most accurately identified failure (AUC=0.89 [95% CI: 0.88 to 0.90]), and an ODI final score of 39 points or more most accurately identified worsening (AUC =0.91 [95% CI: 0.90 - 0.92]). Conclusions: In this national register study, ODI derivates were most accurate to identify both failure and worsening after surgery for degenerative lumbar spinal stenosis. We recommend use of ODI percentage change and ODI final score for further studies of failure and worsening in elective spine surgery.
MeSH term(s)	Aged ; Disability Evaluation ; Female ; Humans ; Lumbar Vertebrae/surgery ; Middle Aged ; Prospective Studies ; Registries ; Retrospective Studies ; Spinal Stenosis/surgery ; Treatment Outcome
Language	English
Publishing date	2021-04-17
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2037072-6
ISSN	1878-1632 ; 1529-9430
ISSN (online)	1878-1632
ISSN	1529-9430
DOI	10.1016/j.spinee.2021.04.008
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Article ; Online: Long-term comparison of anterior (ALIF) versus transforaminal (TLIF) lumbar interbody fusion: a propensity score-matched register-based study.

Alhaug, Ole Kristian / Dolatowski, Filip C / Thyrhaug, Anette Moltu / Mjønes, Sverre / Dos Reis, Joao André Barroso Pereira Roque / Austevoll, Ivar

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

2023 Volume 33, Issue 3, Page(s) 1109–1119

Abstract: Purpose: Anterior (ALIF) and transforaminal (TLIF) lumbar interbody fusion have shown similar clinical outcomes at short- and medium-term follow-ups. Possible advantages of ALIF in the long run could be better disc height and lumbar lordosis and reduced ...

Abstract	Purpose: Anterior (ALIF) and transforaminal (TLIF) lumbar interbody fusion have shown similar clinical outcomes at short- and medium-term follow-ups. Possible advantages of ALIF in the long run could be better disc height and lumbar lordosis and reduced risk of adjacent segment disease. We aimed to study if ALIF could be associated with superior clinical outcomes than TLIF at long-term follow-up. Methods: We analysed 535 patients treated with ALIF or TLIF of the L5-S1 spinal segment between 2007 and 2017 who completed long-term follow-up in a national spine registry database (NORspine). We defined treatment success after surgery as at least 30% improvement in Oswestry Disability Index (ODI) at long-term follow-up. Patients treated with ALIF and TLIF and who responded at long term were balanced by propensity score matching. The proportions of successfully treated patients within each group were compared by numbers and percentages with corresponding relative risk. Results: The mean (95%CI) age of the total study population was 50 (49-51) years, and 264 (49%) were females. The mean (95%CI) preoperative ODI score was 40 (39-42), and 174 (33%) had previous spine surgery. Propensity score matching left 120 patients in each treatment group. At a median (95%CI) of 92 (88-97) months after surgery, we found no difference in proportions successfully treated patients with ALIF versus TLIF (68 (58%) versus 77 (65%), RR (95%CI) = 0.88 (0.72 to1.08); p = 0.237). Conclusions: This propensity score-matched national spine register study of patients treated with ALIF versus TLIF of the lumbosacral junction found no differences in proportions of successfully treated patients at long-term follow-up. Level of evidence i: Diagnostic: individual cross-sectional studies with the consistently applied reference standard and blinding.
MeSH term(s)	Female ; Humans ; Middle Aged ; Male ; Lumbar Vertebrae/surgery ; Propensity Score ; Cross-Sectional Studies ; Spinal Fusion/adverse effects ; Lordosis/surgery ; Treatment Outcome ; Retrospective Studies
Language	English
Publishing date	2023-12-11
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1115375-1
ISSN	1432-0932 ; 0940-6719
ISSN (online)	1432-0932
ISSN	0940-6719
DOI	10.1007/s00586-023-08060-1
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Zs.A 3437: Show issues

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Article ; Online: Eight orthopedic surgeons achieved moderate to excellent reliability measuring the preoperative posterior tilt angle in 50 Garden-I and Garden-II femoral neck fractures.

Dolatowski, Filip C / Hoelsbrekken, Sigurd Erik

Journal of orthopaedic surgery and research

2017 Volume 12, Issue 1, Page(s) 133

Abstract: Background: Studies of elderly patients with Garden-I and Garden-II femoral neck fractures (FNFs) suggest that a preoperative posterior tilt of the femoral head of at least 20° increases the risk of fixation failure. A recently published treatment ... ...

Abstract	Background: Studies of elderly patients with Garden-I and Garden-II femoral neck fractures (FNFs) suggest that a preoperative posterior tilt of the femoral head of at least 20° increases the risk of fixation failure. A recently published treatment algorithm recommended hemiarthroplasty over internal fixation for elderly patients with Garden-I and Garden-II FNFs and a preoperative posterior tilt of at least 20°. However, the reliability of the method used to measure the posterior tilt has not been assessed according to recommended standards for reliability trials. Methods: Four orthopedic registrars and four consultants measured the posterior tilt angle in 50 preoperative lateral radiographs at two occasions six weeks apart. We estimated inter- and intrarater reliability by intraclass correlation coefficient (ICC). We also assessed repeatability by the repeatability coefficient (RC) and agreement by the minimal detectable change (MDC). Based on the suggested cutoff value of 20°, we reported the overall percentage and specific agreement for the choice of implant. Results: Inter- and intrarater reliability for all raters was excellent with an ICC (95% CI) of 0.77 (0.69-0.85) and 0.77 (0.67-0.86), respectively. The RC was 13.9 and the MDC 14.1. Specific agreement for choosing arthroplasty was 61.3 and 54.6% for the first and second test occasion, respectively. Conclusions: Eight orthopedic surgeons measured the posterior tilt in 50 Garden-I and Garden-II FNFs and achieved excellent inter- and intrarater reliability. However, variations in repeated measurements and variations in measurements made by different raters, as assessed by the RC and the MDC respectively, ranged from 13.9° to 14.1°. The variations in posterior tilt measurements should be taken into account when choosing the type of implant for elderly patients with Garden-I and Garden-II femoral neck fractures.
Language	English
Publishing date	2017-09-19
Publishing country	England
Document type	Journal Article
ISSN	1749-799X
ISSN (online)	1749-799X
DOI	10.1186/s13018-017-0632-x
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Article ; Online: The influence of the hips position on measurements of posterior tilt in a valgus-impacted femoral neck fracture.

Hoelsbrekken, Sigurd Erik / Dolatowski, Filip C

Injury

2017 Volume 48, Issue 10, Page(s) 2184–2188

Abstract: Introduction: Lateral radiographs are important for the evaluation of Garden I and II femoral neck fractures. These fractures appear undisplaced in the anteroposterior view, but posterior tilt of the femoral head may still be present in the lateral view. ...

Abstract	Introduction: Lateral radiographs are important for the evaluation of Garden I and II femoral neck fractures. These fractures appear undisplaced in the anteroposterior view, but posterior tilt of the femoral head may still be present in the lateral view. The influence of posterior tilt is, however, debated, which could be caused by the use of non-standardized cross-table radiographs in the conflicting reports. The aim of this bone-model study was therefore to evaluate the influence of the hips position on measurements of posterior tilt. Materials and methods: We generated models of a Garden I-II femoral neck fracture and the non-injured contralateral femur from CT reconstructions with a 3D-printer. Lateral radiographs of the models were obtained in positions ranging from 90° internal rotation (IR) to 90° external rotation (ER) and 0-80° flexion. Two investigators independently measured posterior tilt on 27 lateral radiographs obtained from each model. Results: The inter-tester ICC was 0.91 (0.84-0.94), standard error of measurement (SEM) 2.6, and minimal detectable change (MDC) 7.2. The median (range) posterior tilt for the fracture model was 21.9° (5.0, 33.8) and 23.6° (2.2, 28.6) for observer 1 and observer 2, respectively. The corresponding posterior tilt within the range of 10° IR to 40° ER and 0 to 30° flexion of the fracture model, was 27.3° (24.0, 33.8) and 26.3° (24.8, 28.6). Discussion: The range of posterior tilt measurements for positions of the proximal femur restricted from 10° IR to 40° ER and 0 to 30° flexion, was above the MDC for observer 1, and below the MDC for observer 2. These findings indicate that rotation and flexion affect measurements of posterior tilt, but the influence may be negligible for positions of the injured extremity that are clinically relevant during cross-table lateral radiographs. A larger study that accounts for variations in anatomy and fracture displacement is required to confirm these findings.
MeSH term(s)	Arthroplasty, Replacement, Hip/methods ; Decision Support Techniques ; Femoral Neck Fractures/diagnostic imaging ; Femoral Neck Fractures/surgery ; Femur Head/anatomy & histology ; Femur Head/diagnostic imaging ; Femur Head/injuries ; Humans ; Observer Variation ; Patient Positioning/methods ; Radiography ; Reproducibility of Results
Language	English
Publishing date	2017-10
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2017.08.053
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Zs.A 778: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Impact of the number of previous lumbar operations on patient-reported outcomes after surgery for lumbar spinal stenosis or lumbar disc herniation.

Riksaasen, Anniken S / Kaur, Simran / Solberg, Tore K / Austevoll, Ivar / Brox, Jens-Ivar / Dolatowski, Filip C / Hellum, Christian / Kolstad, Frode / Lonne, Greger / Nygaard, Øystein P / Ingebrigtsen, Tor

The bone & joint journal

2023 Volume 105-B, Issue 4, Page(s) 422–430

Abstract: Repeated lumbar spine surgery has been associated with inferior clinical outcomes. This study aimed to examine and quantify the impact of this association in a national clinical register cohort. This is a population-based study from the Norwegian ... ...

Abstract	Repeated lumbar spine surgery has been associated with inferior clinical outcomes. This study aimed to examine and quantify the impact of this association in a national clinical register cohort. This is a population-based study from the Norwegian Registry for Spine surgery (NORspine). We included 26,723 consecutive cases operated for lumbar spinal stenosis or lumbar disc herniation from January 2007 to December 2018. The primary outcome was the Oswestry Disability Index (ODI), presented as the proportions reaching a patient-acceptable symptom state (PASS; defined as an ODI raw score ≤ 22) and ODI raw and change scores at 12-month follow-up. Secondary outcomes were the Global Perceived Effect scale, the numerical rating scale for pain, the EuroQoL five-dimensions health questionnaire, occurrence of perioperative complications and wound infections, and working capability. Binary logistic regression analysis was conducted to examine how the number of previous operations influenced the odds of not reaching a PASS. The proportion reaching a PASS decreased from 66.0% (95% confidence interval (CI) 65.4 to 66.7) in cases with no previous operation to 22.0% (95% CI 15.2 to 30.3) in cases with four or more previous operations (p < 0.001). The odds of not reaching a PASS were 2.1 (95% CI 1.9 to 2.2) in cases with one previous operation, 2.6 (95% CI 2.3 to 3.0) in cases with two, 4.4 (95% CI 3.4 to 5.5) in cases with three, and 6.9 (95% CI 4.5 to 10.5) in cases with four or more previous operations. The ODI raw and change scores and the secondary outcomes showed similar trends. We found a dose-response relationship between increasing number of previous operations and inferior outcomes among patients operated for degenerative conditions in the lumbar spine. This information should be considered in the shared decision-making process prior to elective spine surgery.
MeSH term(s)	Humans ; Intervertebral Disc Displacement/surgery ; Spinal Stenosis/surgery ; Lumbar Vertebrae/surgery ; Lumbosacral Region ; Patient Reported Outcome Measures ; Treatment Outcome
Language	English
Publishing date	2023-03-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2697156-2
ISSN	2049-4408 ; 2049-4394
ISSN (online)	2049-4408
ISSN	2049-4394
DOI	10.1302/0301-620X.105B4.BJJ-2022-0704.R1
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Zs.A 6989: Show issues

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In stock of ZB MED Cologne/Königswinter

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