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Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
Online ISSN 1973-9095
Den Boer J. J. 1,2, Oostendorp R. A. B. 2,3,4, Evers A. W. M. 5, Beems T. 6, Borm G. F. 7, Munneke M. 1,2
1 Department of Rehabilitation, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands;
2 Research Centre of Allied Health Sciences, University Medical Centre Radboud, Nijmegen, the Netherlands;
3 Centre for Quality of Care Research (WOK), Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands;
4 Dutch Institute of Allied Health Care, Amersfoort, the Netherlands;
5 Department of Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands;
6 Department of Neurosurgery, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands;
7 Department of Epidemiology and Biostatistics, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
AIM: A considerable number of patients who undergo surgery for a lumbosacral radicular syndrome (LRS) continue to experience disability, pain, and loss of work capacity. The goal of the study is to develop a brief screening instrument to identify these patients at risk of residual complaints.
METHODS: In a prospective study of 277 patients, the predictors for the outcomes disability, pain, and loss of work capacity were investigated. The best predictive model was constructed using a stepwise selection procedure (forward selection), which calculates the discriminative power of the model. Based on the relationship between regression coefficients, a clinical prediction rule was derived that predicted the probability of residual complaints after surgery for LRS.
RESULTS: At 6 month follow-up 141 patients (51%) had residual complaints. The discriminative power of the instrument was .78 (AUC). The “Nijmegen Outcome of Lumbar Disc surgery Screening-instrument” (NOLDS) was based on the variables “lower education level”, “younger age”, “pain 3 days postoperatively”, “passive pain coping”, and “fear of movement/(re)injury”.
CONCLUSION: The results of the study are promising, showing that a brief clinical screening instrument can be used to identify patients at risk of residual complaints at 6 months after surgery for LRS. The early identification of patients at risk having residual complaints may make it possible to start tailored treatment early in the rehabilitation process.