title: Determination of the Optimal Cutoff Values for Pain Sensitivity Questionnaire Scores and the Oswestry Disability Index for Favorable Surgical Outcomes in Subjects With Lumbar Spinal Stenosis.
abstract: METHODS
  Retrospective analysis of prospectively collected data (NCT02134821).
  
  
  OBJECTIVE
  The aim of this study was to elucidate the cutoff values for significant predictors for favorable outcomes after lumbar spine surgery in patients with lumbar spinal stenosis (LSS).
  
  
  BACKGROUND
  Various factors are associated with the surgical outcomes for patients with LSS. However, we did not know the odds ratio and/or cutoff values of a predictive factor for a favorable surgical outcome for LSS.
  
  
  METHODS
  A total of 157 patients who underwent spine surgery due to LSS between June 2012 and April 2013 were included in this study. The patients were dichotomized into 2 groups on the basis of an Oswestry Disability Index (ODI) score of 22 or less (favorable outcome group) or more than 22 (unfavorable outcome group) at 12 months after surgery. Regarding favorable outcomes, the odds ratio for each preoperative variable including demographic data, preoperative symptom severity, and pain sensitivity questionnaire (PSQ) score was calculated using univariate and multivariate logistic regression analyses. For the significant variables for surgical outcome, receiver operating characteristic (ROC) curve was plotted with calculation of the area under the ROC curve.
  
  
  RESULTS
  Multivariate analysis revealed that the ODI and total PSQ scores were significantly associated with a greater likelihood of an unfavorable surgical outcome [odds ratio (95% confidence interval) of ODI, 1.289 (1.028-1.616); odds ratio (95% confidence interval) of total PSQ, 1.060 (1.009-1.113)]. ROC analysis revealed area under the ROC curves for the total PSQ and ODI scores of 0.638 (P = 0.005) and 0.692 (P < 0.001), respectively.
  
  
  CONCLUSIONS
  Preoperative disability and pain sensitivity can be predictors of the functional level achieved after spine surgery in patients with LSS, and the ideal cutoff values for the total PSQ and ODI scores were 6.6 and 45.0, respectively.
authors.affiliation: *Spine Center and Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Sungnam, Republic of Korea†Department of Mechanical Engineering, Yonsei University, Seodaemun-gu, Seoul, Republic of Korea‡Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea; and§Department of Orthopaedic Surgery, Pusan National University, School of Medicine and Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
authors.forename: Ho-Joong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Jong-Woong
authors.initials: JW
authors.lastname: Park
authors.forename: Kyoung-Tak
authors.initials: KT
authors.lastname: Kang
authors.forename: Bong-Soon
authors.initials: BS
authors.lastname: Chang
authors.forename: Choon-Ki
authors.initials: CK
authors.lastname: Lee
authors.forename: Sung-Shik
authors.initials: SS
authors.lastname: Kang
authors.forename: Jin S
authors.initials: JS
authors.lastname: Yeom
mesh_terms: D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D017288:Pain Threshold; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013123:Spinal Fusion; D013130:Spinal Stenosis / Q000473:pathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome