PMID- 27509192
OWN - NLM
STAT- MEDLINE
DCOM- 20170807
LR  - 20210114
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 42
IP  - 7
DP  - 2017 Apr 1
TI  - The Influence of Pre- and Postoperative Fear Avoidance Beliefs on Postoperative 
      Pain and Disability in Patients With Lumbar Spinal Stenosis: Analysis of the 
      Lumbar Spinal Outcome Study (LSOS) Data.
PG  - E425-E432
LID - 10.1097/BRS.0000000000001845 [doi]
AB  - STUDY DESIGN: Prospective multicenter cohort study. OBJECTIVE: To evaluate the 
      effect of pre- and postoperatively assessed fear avoidance beliefs (FAB) on pain 
      and disability in patients with degenerative lumbar spinal stenosis (LSS) after 
      decompression surgery. SUMMARY OF BACKGROUND DATA: To the present, the influence 
      of pre- and postoperative FAB on the prognosis after surgery for LLS is still 
      unclear. METHODS: Patients of the Swiss Lumbar Stenosis Outcome Study (LSOS) with 
      confirmed LSS undergoing first-time decompression without fusion were enrolled in 
      this study. The main outcome of this study was minimal clinically important 
      difference (MCID) in spinal stenosis measure symptoms (pain) and function 
      (disability) after 12 months. To analyze the influence of pre- and 
      postoperatively assessed FAB on pain and disability we built simple and multiple 
      logistic regression models. RESULTS: In this analysis of 234 patients undergoing 
      decompression surgery for symptomatic degenerative LSS we found baseline FAB 
      measured by the FAB physical activity subscale (FABQ-P) not to be associated with 
      pain (OR 0.95; 95% CI: 0.55-1.67) and disability (OR 1.11; 95% CI: 0.64-1.92) at 
      12 months' follow-up. In the final multiple logistic regression models patients 
      with high FABQ-P at 6 months (OR 0.46; 95% CI: 0.24-0.91) and high persistent 
      FABQ-P at baseline and 6 months (OR 0.34, 95% CI: 0.16-0.73) were less likely to 
      report a MCID for spinal stenosis measure symptoms at 12 months. Our analysis 
      found a similar trend for disability; however, the results were not statistically 
      significant. CONCLUSION: In elderly patients undergoing decompression surgery for 
      symptomatic degenerative LSS preoperative fear avoidance beliefs were not a 
      prognostic indicator for the outcome. Patients with FAB at 6 months and 
      persistent FAB were less likely to experience clinically relevant improvement in 
      pain at 12 months. Studies should address the importance of persistent 
      postoperative FAB. LEVEL OF EVIDENCE: 3.
FAU - Burgstaller, Jakob M
AU  - Burgstaller JM
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of 
      Zurich, Zurich, Switzerland.
AD  - Department of Anesthesiology and Pain Therapy, University Hospital Maastricht, 
      Maastricht, The Netherlands.
FAU - Wertli, Maria M
AU  - Wertli MM
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of 
      Zurich, Zurich, Switzerland.
AD  - Department of General Internal Medicine, Bern University Hospital, Bern 
      University, Bern, Switzerland.
FAU - Steurer, Johann
AU  - Steurer J
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of 
      Zurich, Zurich, Switzerland.
FAU - Kessels, Alfons G H
AU  - Kessels AGH
AD  - Department of Anesthesiology and Pain Therapy, University Hospital Maastricht, 
      Maastricht, The Netherlands.
FAU - Held, Ulrike
AU  - Held U
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of 
      Zurich, Zurich, Switzerland.
FAU - Gramke, Hans-Fritz
AU  - Gramke HF
AD  - Department of Anesthesiology and Pain Therapy, University Hospital Maastricht, 
      Maastricht, The Netherlands.
CN  - LSOS Study Group
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Avoidance Learning
MH  - Cohort Studies
MH  - Decompression, Surgical/adverse effects/trends
MH  - Disabled Persons
MH  - Fear/*psychology
MH  - Female
MH  - Follow-Up Studies
MH  - Health Knowledge, Attitudes, Practice
MH  - Humans
MH  - *Lumbar Vertebrae/pathology/surgery
MH  - Male
MH  - Pain Measurement/*psychology/trends
MH  - Pain, Postoperative/diagnosis/*psychology
MH  - Preoperative Care/*psychology/trends
MH  - Prospective Studies
MH  - Spinal Stenosis/diagnosis/*psychology/surgery
MH  - Treatment Outcome
EDAT- 2016/08/11 06:00
MHDA- 2017/08/08 06:00
CRDT- 2016/08/11 06:00
PHST- 2016/08/11 06:00 [pubmed]
PHST- 2017/08/08 06:00 [medline]
PHST- 2016/08/11 06:00 [entrez]
AID - 00007632-201704010-00021 [pii]
AID - 10.1097/BRS.0000000000001845 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2017 Apr 1;42(7):E425-E432. doi: 
      10.1097/BRS.0000000000001845.