Does back pain catastrophizing influence 60-month surgical outcomes for patients with degenerative lumbar spondylolisthesis? A Quality Outcomes Database study.
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| Název: | Does back pain catastrophizing influence 60-month surgical outcomes for patients with degenerative lumbar spondylolisthesis? A Quality Outcomes Database study. |
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| Autoři: | Yang E; 1Department of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons, The Och Spine Hospital at NewYork-Presbyterian, New York, New York., Schonfeld E; 1Department of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons, The Och Spine Hospital at NewYork-Presbyterian, New York, New York., Boyett D; 1Department of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons, The Och Spine Hospital at NewYork-Presbyterian, New York, New York., Mummaneni PV; 2Department of Neurosurgery, University of California, San Francisco, California., Chou D; 1Department of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons, The Och Spine Hospital at NewYork-Presbyterian, New York, New York., Bydon M; 3Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota., Bisson EF; 4Department of Neurosurgery, University of Utah, Salt Lake City, Utah., Shaffrey CI; 5Department of Neurosurgery, Duke University, Durham, North Carolina., Glassman SD; 6Norton Leatherman Spine Center, Louisville, Kentucky., Foley KT; 7Department of Neurosurgery, University of Tennessee Semmes Murphey Neurologic and Spine Institute, Memphis, Tennessee., Potts EA; 8Goodman Campbell Brain and Spine, Indianapolis, Indiana., Yen CP; 9Department of Neurosurgery, University of Virginia, Charlottesville, Virginia., Coric D; 10Neuroscience Institute, Carolinas Healthcare System and Carolina Neurosurgery & Spine Associates, Charlotte, North Carolina., Knightly JJ; 11Atlantic Neurosurgical Specialists, Morristown, New Jersey., Park P; 7Department of Neurosurgery, University of Tennessee Semmes Murphey Neurologic and Spine Institute, Memphis, Tennessee., Wang MY; 12Department of Neurosurgery, University of Miami, Florida., Fu KM; 13Department of Neurosurgery, Weill Cornell Medical Center, New York, New York., Slotkin JR; 14Department of Neurosurgery, Geisinger Health, Danville, Pennsylvania; and., Asher AL; 10Neuroscience Institute, Carolinas Healthcare System and Carolina Neurosurgery & Spine Associates, Charlotte, North Carolina., Virk MS; 13Department of Neurosurgery, Weill Cornell Medical Center, New York, New York., Haid RW; 15Atlanta Brain and Spine Care, Atlanta, Georgia., Chan AK; 1Department of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons, The Och Spine Hospital at NewYork-Presbyterian, New York, New York. |
| Zdroj: | Journal of neurosurgery. Spine [J Neurosurg Spine] 2025 Aug 08; Vol. 43 (5), pp. 529-539. Date of Electronic Publication: 2025 Aug 08 (Print Publication: 2025). |
| Způsob vydávání: | Journal Article |
| Jazyk: | English |
| Informace o časopise: | Publisher: American Association of Neurological Surgeons Country of Publication: United States NLM ID: 101223545 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 1547-5646 (Electronic) Linking ISSN: 15475646 NLM ISO Abbreviation: J Neurosurg Spine Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Charlottesville, VA : American Association of Neurological Surgeons, c2004- |
| Výrazy ze slovníku MeSH: | Spondylolisthesis*/surgery , Spondylolisthesis*/psychology , Spondylolisthesis*/complications , Catastrophization*/psychology , Lumbar Vertebrae*/surgery , Back Pain*/psychology , Back Pain*/surgery, Humans ; Female ; Male ; Middle Aged ; Aged ; Treatment Outcome ; Databases, Factual ; Patient Reported Outcome Measures ; Pain Measurement ; Low Back Pain/surgery ; Low Back Pain/psychology |
| Abstrakt: | Objective: Degenerative lumbar spondylolisthesis is a common cause of back and leg pain influenced by factors like instability, disc degeneration, facet arthropathy, and psychosocial phenotype. Patients' experience of high-severity pain is complex, with significant implications for surgical planning. The goal of this study was to assess the impact of back pain catastrophizing on long-term outcomes following lumbar spondylolisthesis surgery. Methods: This study uses the Quality Outcomes Database (QOD) lumbar spondylolisthesis dataset and includes prospectively collected data from the 12 highest-enrolling clinical sites participating in the QOD lumbar module. The authors reviewed patients undergoing single-segment surgery for grade 1 degenerative lumbar spondylolisthesis. Severe baseline numeric rating scale for back pain (NRS-BP) scores (≥ 8) were classified as "catastrophizing," and mild to moderate pain scores (< 8) were classified as "non-catastrophizing." Patient-reported outcomes (PROs) were compared for catastrophizing versus non-catastrophizing patients at 60 months. Univariate and multivariate analyses were conducted to assess the impact of catastrophizing on PROs, with multivariate analysis controlling for variables initially reaching a p value < 0.10. Results: Of the 608 patients in this analysis, 260 (42.8%) experienced catastrophizing while 348 (57.2%) did not. Catastrophizing patients were significantly younger (59.9 ± 12.2 years vs 63.9 ± 11.7 years, p < 0.001), less often had ≥ 4 years of college education (31.2% vs 42.5%, p = 0.004), and more often used private insurance (58.8% vs 47.7%, p = 0.01). The catastrophizing cohort also had higher rates of depression (24.6% vs 17.0%, p = 0.02) and back pain predominance (45.4% vs 32.2%, p < 0.001). Surgical and perioperative characteristics did not significantly differ between cohorts. Although catastrophizing patients typically reported worse PRO scores at both baseline and 60 months, they demonstrated significantly greater improvement and minimal clinically important difference (MCID) achievement across almost all PROs at 60 months (p < 0.05). However, North American Spine Society (NASS) satisfaction scores at 60 months did not differ significantly between cohorts. Multivariate analysis found that catastrophizing significantly predicted 60-month NRS-BP change (β -1.45, 95% CI -1.81 to -1.09; p < 0.001) and MCID achievement (OR 1.98, 95% CI 1.52-2.58; p < 0.001) but not mean NRS-BP score or other metrics, including NASS satisfaction. Conclusions: Despite presenting with worse baseline symptoms, patients with pain catastrophizing experienced substantial and clinically meaningful improvement following surgery for degenerative lumbar spondylolisthesis. Patient satisfaction was comparable between cohorts, reflecting a nuanced balance between greater absolute improvement and persistence of residual symptoms. These findings underscore that catastrophizing should not be viewed as a barrier to surgical success, while pointing to the need for proactive expectation setting and shared decision-making. |
| Contributed Indexing: | Keywords: Quality Outcomes Database; back pain severity; degenerative lumbar spondylolisthesis; pain catastrophizing; surgical outcomes |
| Entry Date(s): | Date Created: 20250808 Date Completed: 20251101 Latest Revision: 20251101 |
| Update Code: | 20251102 |
| DOI: | 10.3171/2025.5.SPINE25310 |
| PMID: | 40779803 |
| Databáze: | MEDLINE |
Nájsť tento článok vo Web of Science | Abstrakt: | Objective: Degenerative lumbar spondylolisthesis is a common cause of back and leg pain influenced by factors like instability, disc degeneration, facet arthropathy, and psychosocial phenotype. Patients' experience of high-severity pain is complex, with significant implications for surgical planning. The goal of this study was to assess the impact of back pain catastrophizing on long-term outcomes following lumbar spondylolisthesis surgery.<br />Methods: This study uses the Quality Outcomes Database (QOD) lumbar spondylolisthesis dataset and includes prospectively collected data from the 12 highest-enrolling clinical sites participating in the QOD lumbar module. The authors reviewed patients undergoing single-segment surgery for grade 1 degenerative lumbar spondylolisthesis. Severe baseline numeric rating scale for back pain (NRS-BP) scores (≥ 8) were classified as "catastrophizing," and mild to moderate pain scores (< 8) were classified as "non-catastrophizing." Patient-reported outcomes (PROs) were compared for catastrophizing versus non-catastrophizing patients at 60 months. Univariate and multivariate analyses were conducted to assess the impact of catastrophizing on PROs, with multivariate analysis controlling for variables initially reaching a p value < 0.10.<br />Results: Of the 608 patients in this analysis, 260 (42.8%) experienced catastrophizing while 348 (57.2%) did not. Catastrophizing patients were significantly younger (59.9 ± 12.2 years vs 63.9 ± 11.7 years, p < 0.001), less often had ≥ 4 years of college education (31.2% vs 42.5%, p = 0.004), and more often used private insurance (58.8% vs 47.7%, p = 0.01). The catastrophizing cohort also had higher rates of depression (24.6% vs 17.0%, p = 0.02) and back pain predominance (45.4% vs 32.2%, p < 0.001). Surgical and perioperative characteristics did not significantly differ between cohorts. Although catastrophizing patients typically reported worse PRO scores at both baseline and 60 months, they demonstrated significantly greater improvement and minimal clinically important difference (MCID) achievement across almost all PROs at 60 months (p < 0.05). However, North American Spine Society (NASS) satisfaction scores at 60 months did not differ significantly between cohorts. Multivariate analysis found that catastrophizing significantly predicted 60-month NRS-BP change (β -1.45, 95% CI -1.81 to -1.09; p < 0.001) and MCID achievement (OR 1.98, 95% CI 1.52-2.58; p < 0.001) but not mean NRS-BP score or other metrics, including NASS satisfaction.<br />Conclusions: Despite presenting with worse baseline symptoms, patients with pain catastrophizing experienced substantial and clinically meaningful improvement following surgery for degenerative lumbar spondylolisthesis. Patient satisfaction was comparable between cohorts, reflecting a nuanced balance between greater absolute improvement and persistence of residual symptoms. These findings underscore that catastrophizing should not be viewed as a barrier to surgical success, while pointing to the need for proactive expectation setting and shared decision-making. |
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| ISSN: | 1547-5646 |
| DOI: | 10.3171/2025.5.SPINE25310 |