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. 2017 Mar;42(5):E272-E279.
doi: 10.1097/BRS.0000000000001773.

Prognostic Factors for Persistent Leg-Pain in Patients Hospitalized With Acute Sciatica

Olaf Fjeld  1   2   3 , Margreth Grotle  1   4 , Vibeke Siewers  1   2 , Linda M Pedersen  1 , Kristian Bernhard Nilsen  1   2   5   6 , John-Anker Zwart  1   2   3
Affiliations

Prognostic Factors for Persistent Leg-Pain in Patients Hospitalized With Acute Sciatica

Olaf Fjeld et al. Spine (Phila Pa 1976). 2017 Mar.

Abstract

Study design: Prospective cohort study.

Objective: To identify potential prognostic factors for persistent leg-pain at 12 months among patients hospitalized with acute severe sciatica.

Summary of background data: The long-term outcome for patients admitted to hospital with sciatica is generally unfavorable. Results concerning prognostic factors for persistent sciatica are limited and conflicting.

Methods: A total of 210 patients acutely admitted to hospital for either surgical or nonsurgical treatment of sciatica were consecutively recruited and received a thorough clinical and radiographic examination in addition to responding to a comprehensive questionnaire. Follow-up assessments were done at 6 weeks, 6 months, and 12 months. Potential prognostic factors were measured at baseline and at 6 weeks. The impact of these factors on leg-pain was analyzed by multiple linear regression modeling.

Results: A total of 151 patients completed the entire study, 93 receiving nonrandomized surgical treatment. The final multivariate models showed that the following factors were significantly associated with leg-pain at 12 months: high psychosocial risk according to the Örebro Musculosceletal Pain Questionnaire (unstandardized beta coefficient 1.55, 95% confidence interval [CI] 0.72-2.38, P < 0.001), not receiving surgical treatment (1.11, 95% CI 0.29-1.93, P = 0.01), not actively employed upon admission (1.47, 95% CI 0.63-2.31, P < 0.01), and self-reported leg-pain recorded 6 weeks posthospital admission (0.49, 95% CI 0.34-0.63, P < 0.001). Interaction analysis showed that the Örebro Musculosceletal Pain Questionnaire had significant prognostic value only on the nonsurgically treated patients (3.26, 95% CI 1.89-4.63, P < 0.001).

Conclusion: The results suggest that a psychosocial screening tool and the implementation of a 6-week postadmission follow-up has prognostic value in the hospital management of severe sciatica.

Level of evidence: 2.

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