Effect of Fibromyalgia Symptoms on Outcome of Spinal Surgery.
To evaluate the effect of presurgical symptoms characteristic of fibromyalgia on the postsurgical outcome of patients undergoing spinal surgery.



In this observational cohort study, participants were patients scheduled for spinal surgery, including cervical or lumbar laminectomy and foraminectomy. Presurgical evaluation included physical examination and manual dolorimetry. Questionnaires included the widespread pain index (WPI), symptom severity scale (SSS), and SF-36. Postsurgical evaluation performed at 10-12 weeks included questionnaires, physical examination, and dolorimetry.



Forty patients (21 male, 19 female) were recruited. Four patients (10%) fulfilled American College of Rheumatology (ACR) 1990 fibromyalgia; nine patients fulfilled 2010 criteria (22.5%). Overall, a significant 34% reduction in WPI was observed postsurgically ( P  < 0.01), but no significant change was observed in SSS. Comparing outcomes for patients fulfilling and not fulfilling fibromyalgia criteria, fibromyalgia syndrome (FMS)-negative patients experienced highly significant reductions of both SSS and WPI (-50.1% and -42.9%, respectively, P  < 0.01), while FMS-positive patients experienced no reduction of SSS symptoms and only a marginally significant reduction in WPI (-20.3%, P  = 0.04). A significant negative correlation was observed between results of presurgical WPI and change in physical role functioning SF-36 component postsurgically. A significant negative correlation was observed between presurgical SSS and change in composite physical functioning SF-36 component. Regression analysis demonstrated a difference in trend between FMS-positive and FMS-negative patients regarding postop changes in SSS, as well as a difference in trend regarding the general health role limitation due to emotional problems and pain components of the SF-36.



Fibromyalgia symptoms were highly prevalent among patients scheduled for spinal surgery. A negative correlation was observed between presurgical severity of fibromyalgia symptoms and components of postsurgical SF-36. Patients with symptoms typical of fibromyalgia may have a less favorable outcome after spinal surgery. The clinical utility of surgical intervention in such patients should be carefully evaluated, and treatment specific for fibromyalgia might be considered before embarking on a surgical course.
Institute of Rheumatology,  Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Jacob N
JN
Ablin
Institute of Rheumatology,  Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Mark
M
Berman
Institute of Rheumatology,  Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Valerie
V
Aloush
Department of Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Gilad
G
Regev
Department of Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Khalil
K
Salame
Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
Dan
D
Buskila
Department of Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Zvi
Z
Lidar
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D059350:Chronic Pain / Q000000981:diagnostic imaging / Q000517:prevention & control* / Q000601:surgery*; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D007796:Laminectomy / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D012307:Risk Factors; D063189:Symptom Assessment / Q000706:statistics & numerical data; D016896:Treatment Outcome
Fibromyalgia; Presurgical Evaluation; Spinal Surgery