title: Pain and disability following first-time lumbar fusion surgery for degenerative disorders: a systematic review protocol.
abstract: BACKGROUND
  Lumbar spinal fusion for degenerative disorders of the lumbar spine is frequently used, despite current research presenting inconclusive evidence. This study aims to systematically review and meta-analyse the natural course of pain and disability in patients with degenerative disorders of the lumbar spine such as spinal stenosis, spondylolisthesis, disc herniation, or discogenic low back pain to improve lumbar spinal fusion management.
  
  
  METHODS
  An electronic database search will be conducted up to 30 September 2015 using MEDLINE, EMBASE, CINAHL, and ZETOC database. In addition, a search for articles in press and published ahead of print, British National Bibliography for Report Literature, and OpenGrey will be conducted. Prospective cohort studies using outcome measures of pain and disability will be eligible for inclusion. Two reviewers will screen titles, abstracts, and full-text independently using predetermined inclusion and exclusion criteria. The risk of bias of included studies will be assessed with the modified version of the Quality in Prognostic Studies tool. If meta-analysis of outcome data is deemed appropriate, variance-weighted pooled means will be calculated.
  
  
  CONCLUSIONS
  The results of this systematic review and meta-analysis may improve understanding of recovery after lumbar spinal fusion and improve lumbar spinal fusion management.
  
  
  BACKGROUND
  PROSPERO CRD42015026922.
authors.affiliation: Department of Physiotherapy, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands. niek.koenders@radboudumc.nl.
authors.forename: Niek
authors.initials: N
authors.lastname: Koenders
authors.affiliation: School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Rushton
authors.affiliation: School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Heneghan
authors.affiliation: Department of Physiotherapy, Bern University Hospital, Bern, Switzerland.
authors.forename: Martin L
authors.initials: ML
authors.lastname: Verra
authors.affiliation: Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Willems
authors.affiliation: Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hoogeboom
authors.affiliation: Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands.|Research Group Musculoskeletal Rehabilitation, HAN University of Applied Sciences, Nijmegen, The Netherlands.
authors.forename: J Bart
authors.initials: JB
authors.lastname: Staal
mesh_terms: D000203:Activities of Daily Living; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000601:surgery; D007405:Intervertebral Disc Displacement / Q000601:surgery; D017116:Low Back Pain / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D010149:Postoperative Pain; D011379:Prognosis; D013122:Spinal Diseases / Q000601:surgery*; D013123:Spinal Fusion; D013130:Spinal Stenosis / Q000601:surgery; D013168:Spondylolisthesis / Q000601:surgery; D000078202:Systematic Reviews as Topic; D015201:Meta-Analysis as Topic
keywords: Disability; Herniated disc; Pain; Spinal fusion; Spinal stenosis; Spinal surgery; Spondylolisthesis