Prognostic Factors for Persistent Leg-Pain in Patients Hospitalized With Acute Sciatica
- PMID: 28244968
- DOI: 10.1097/BRS.0000000000001773
Prognostic Factors for Persistent Leg-Pain in Patients Hospitalized With Acute Sciatica
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.
References
-
- van Tulder MW, Koes BW, Bouter LM. A cost-of-illness study of back pain in The Netherlands. Pain 1995; 62:233–240.
-
- Nykvist F, Hurme M, Alaranta H, et al. Severe sciatica: a 13-year follow-up of 342 patients. Eur Spine J 1995; 4:335–338.
-
- Balagué F, Nordin M, Sheikhzadeh A, et al. Recovery of severe sciatica. Spine 1999; 24:2516–2524.
-
- Koes BW, van Tulder MW, Peul WC. Diagnosis and treatment of sciatica. BMJ 2007; 334:1313–1317.
-
- Berthelot JM, Glemarec J, Laborie Y, et al. Reasons for rheumatology department admission in 125 patients with disk-related sciatica. Rev Rhum Engl Ed 1999; 66:267–270.
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials