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Michalak M, Druszcz A, Miś M, Paprocka-Borowicz M, Rosińczuk J. Quality of Life, Disability Level, and Pain Intensity among Patients after Lumbar Disc Surgery: An Observational Three-Month Follow-Up Study. Healthcare (Basel) 2023; 11:3127. [PMID: 38132017 PMCID: PMC10742899 DOI: 10.3390/healthcare11243127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/22/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023] Open
Abstract
The prevalence of intervertebral disc degeneration in the lumbar region resulting in low back pain is high. One of the treatment options is neurosurgery. Previous studies and systematic reviews demonstrate the need to identify factors that affect the health-related quality of life of patients undergoing surgery. This study aimed to analyze the sociodemographic and clinical factors that affect the quality of life of patients undergoing lumbar disc surgery. A group of 128 patients was assessed for eligibility and qualified by radiological examinations for lumbar disc surgery by a neurosurgeon in the outpatient clinic. Finally, 110 patients were studied and evaluated 24 h and 3 months after surgery. Health-related quality of life (36-Item Short Form Survey, SF-36), disability level (Oswestry Disability Index, ODI), and pain intensity (Visual Analogue Scale, VAS) were assessed. The mean pain intensity before surgery was 7.8 ± 2.3 pts and decreased significantly 24 h after surgery, with a mean score of 3.8 ± 2.4 pts (p = 0.0000). After three months, the increase in pain intensity was at 4.8 ± 2.4 pts, but the score was still significantly better than before surgery (p = 0.0024). The mean ODI score before surgery was 29.3 ± 8.4 pts (slight disability), and three months after surgery, there was an insignificant increase to a mean value of 31.5 ± 10.4 pts (p = 0.0834). There was a statistically significant increase in quality-of-life scores at three months after surgery in the following domains: physical functioning (8.7%; p = 0.0176), bodily pain (26.2%; p = 0.0000), vitality (5.8%; p = 0.0132) and mental health (6.2%; p = 0.0163), and a decrease in role limitations due to physical problems (3.8; p = 0.0013) and general health perception (6.7%; p = 0.0112). In conclusion, the surgical procedure plays an important role in improving the quality of life of patients operated on for intervertebral disc degeneration. It was effective in reducing the pain level, especially 24 h after surgery; however, surgery did not affect the disability level.
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Affiliation(s)
- Monika Michalak
- Department of Nursing and Obstetrics, Wroclaw Medical University, 51-618 Wroclaw, Poland;
| | - Adam Druszcz
- Department of Neurosurgery, Provincial Specialist Hospital in Legnica, 59-220 Legnica, Poland;
| | - Maciej Miś
- Department of Neurosurgery, Specialist Hospital in Walbrzych, 58-309 Walbrzych, Poland;
| | | | - Joanna Rosińczuk
- Department of Nursing and Obstetrics, Wroclaw Medical University, 51-618 Wroclaw, Poland;
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Chen Q, Wang Z, Zhang S. Mechanism, application and effect evaluation of nerve mobilization in the treatment of low back pain: A narrative review. Medicine (Baltimore) 2023; 102:e34961. [PMID: 37653794 PMCID: PMC10470699 DOI: 10.1097/md.0000000000034961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/14/2023] [Accepted: 08/04/2023] [Indexed: 09/02/2023] Open
Abstract
Lower back pain is a prevalent condition affecting people across all age groups and causing significant personal and societal burdens. While numerous treatments exist, nerve mobilization has emerged as a promising approach for managing lower back pain. Nerve mobilization involves applying gentle and rhythmic movements to the affected nerves, promoting normal nerve function and releasing tension. It has been well documented that nerve mobilization can be effective in reducing pain and improving function in patients with lower back pain, but the underlying mechanisms have not been clarified. This study aims to review the mechanisms of nerve mobilization in the management of lower back pain, its application, and effectiveness evaluation, and provide a potential solution for managing lower back pain.
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Affiliation(s)
- Quanzheng Chen
- Department of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Zhenshan Wang
- Department of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Shuna Zhang
- Department of Physical Education and Health, Guangxi Normal University, Guilin, China
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Yagi M, Michikawa T, Yamamoto T, Iga T, Ogura Y, Tachibana A, Miyamoto A, Suzuki S, Nori S, Takahashi Y, Tsuji O, Nagoshi N, Kono H, Ogawa J, Matsumoto M, Nakamura M, Watanabe K. Development and validation of machine learning-based predictive model for clinical outcome of decompression surgery for lumbar spinal canal stenosis. Spine J 2022; 22:1768-1777. [PMID: 35760319 DOI: 10.1016/j.spinee.2022.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/31/2022] [Accepted: 06/16/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Although the results of decompression surgery for lumbar spinal canal stenosis (LSS) are favorable, it is still difficult to predict the postoperative health-related quality of life of patients before surgery. PURPOSE The purpose of this study was to develop and validate a machine learning model to predict the postoperative outcome of decompression surgery for patients with LSS. STUDY DESIGN/SETTING A multicentered retrospective study. PATIENT SAMPLE A total of 848 patients who underwent decompression surgery for LSS at an academic hospital, tertiary center, and private hospital were included (age 71±9 years, 68% male, 91% LSS, level treated 1.8±0.8, operation time 69±37 minutes, blood loss 48±113 mL, and length of hospital stay 12±5 days). OUTCOME MEASURES Baseline and 2 years postoperative health-related quality of life. METHODS The subjects were randomly assigned in a 7:3 ratio to a model building cohort and a testing cohort to test the models' accuracy. Twelve predictive algorithms using 68 preoperative factors were used to predict each domain of the Japanese Orthopedic Association Back Pain Evaluation Questionnaire and visual analog scale scores at 2 years postoperatively. The final predictive values were generated using an ensemble of the top five algorithms in prediction accuracy. RESULTS The correlation coefficients of the top algorithms for each domain established using the preoperative factors were excellent (correlation coefficient: 0.95-0.97 [relative error: 0.06-0.14]). The performance evaluation of each Japanese Orthopedic Association Back Pain Evaluation Questionnaire domain and visual analog scale score by the ensemble of the top five algorithms in the testing cohort was favorable (mean absolute error [MAE] 8.9-17.4, median difference [MD] 8.1-15.6/100 points), with the highest accuracy for mental status (MAE 8.9, MD 8.1) and the lowest for buttock and leg numbness (MAE 1.7, MD 1.6/10 points). A strong linear correlation was observed between the predicted and measured values (linear correlation 0.82-0.89), while 4% to 6% of the subjects had predicted values of greater than±3 standard deviations of the MAE. CONCLUSIONS We successfully developed a machine learning model to predict the postoperative outcomes of decompression surgery for patients with LSS using patient data from three different institutions in three different settings. Thorough analyses for the subjects with deviations from the actual measured values may further improve the predictive probability of this model.
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Affiliation(s)
- Mitsuru Yagi
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku, Tokyo JAPAN
| | - Takehiro Michikawa
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16 Omori Nishi, Otaku, Tokyo, Japan
| | - Tatsuya Yamamoto
- Department of Orthopedic Surgery, Japanese Red Cross Shizuoka Hospital, 8-2 Otemachi Aoiku Shizuoka city, Shizuoka, Japan
| | - Takahito Iga
- Department of Orthopedic Surgery, Keiyu Orthopedic Hospital, Tatebayashi-shi Akodacho 2267-1, Gunma, Japan
| | - Yoji Ogura
- Department of Orthopedic Surgery, Tachikawa Hospital, 4-2-22 Nishiki-cho, Tachikawa-shi, Tokyo, Japan
| | - Atsuko Tachibana
- Department of Orthopedic Surgery, Keiyu Orthopedic Hospital, Tatebayashi-shi Akodacho 2267-1, Gunma, Japan
| | - Azusa Miyamoto
- Department of Rehabilitation Medicine, Keiyu Orthopedic Hospital, Tatebayashi-shi Akodacho 2267-1, Gunma, Japan
| | - Satoshi Suzuki
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku, Tokyo JAPAN
| | - Satoshi Nori
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku, Tokyo JAPAN
| | - Yohei Takahashi
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku, Tokyo JAPAN
| | - Osahiko Tsuji
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku, Tokyo JAPAN
| | - Narihito Nagoshi
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku, Tokyo JAPAN
| | - Hitoshi Kono
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku, Tokyo JAPAN
| | - Jun Ogawa
- Department of Orthopedic Surgery, Japanese Red Cross Shizuoka Hospital, 8-2 Otemachi Aoiku Shizuoka city, Shizuoka, Japan
| | - Morio Matsumoto
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku, Tokyo JAPAN
| | - Masaya Nakamura
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku, Tokyo JAPAN
| | - Kota Watanabe
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku, Tokyo JAPAN.
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