title: Residual complaints following lumbar disc surgery: prognostic indicators of outcome.
abstract: Physical as well as psychological features might be important prognostic factors for residual complaints following lumbar disc surgery in primary care. No studies have yet investigated both factors simultaneously. The aim of this prospective cohort study was to identify indicators of the short and long-term outcome of residual complaints following lumbar disc surgery. Patients (n=105), aged between 18 and 65 years, were included if they still suffered residual complaints 6 weeks after first-time lumbar disc surgery and had therefore been referred to physiotherapy. All potential indicators were measured at baseline except treatment expectancy, which was measured after two treatment sessions enabling patients to rate treatment expectancy based on their actual perception of the treatment. Dimensions of recovery included perceived recovery, functional status, and pain intensity (back and leg) at the 3-month and 12-month follow-up. It was found that high treatment expectancy was associated with a favorable outcome on perceived recovery and functional status, both at the 3 and the 12-month follow-up. Taking pain medication and a poor functional status at baseline were associated with poor perceived recovery and functional status at both follow-up measurements. Leg pain and back pain at baseline were associated with residual leg and back pain at the 3 and the 12-month follow-up, respectively. The results for perceived recovery and functional status were rather robust. However, for leg pain and back pain, the results were less stable. Apparently, the clinical course to recovery of residual leg pain and residual back pain is not strongly influenced by these indicators.
authors.affiliation: VU University Medical Center, EMGO Institute, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. r.ostelo@vumc.nl
authors.forename: Raymond W J G
authors.initials: RW
authors.lastname: Ostelo
authors.forename: Johan W S
authors.initials: JW
authors.lastname: Vlaeyen
authors.forename: Piet A
authors.initials: PA
authors.lastname: van den Brandt
authors.forename: Henrica C W
authors.initials: HC
authors.lastname: de Vet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010149:Postoperative Pain / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation*; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome