PT  - JOURNAL ARTICLE
AU  - Divi, Srikanth N.
AU  - Woods, Barrett I.
AU  - Goyal, Dhruv K.C.
AU  - Galetta, Matthew S.
AU  - Nicholson, Kristen J.
AU  - Dimatteo, Andrew L.
AU  - Lam, Meghan E.
AU  - Qureshi, Mahir A.
AU  - Anderson, D. Greg
AU  - Kurd, Mark F.
AU  - Rihn, Jeffrey A.
AU  - Kaye, Ian D.
AU  - Kepler, Christopher K.
AU  - Hilibrand, Alan S.
AU  - Vaccaro, Alexander R.
AU  - Radcliff, Kristen E.
AU  - Schroeder, Gregory D.
TI  - Do Patients with Back Pain-Dominant Symptoms Improve After Lumbar Surgery for Radiculopathy or Claudication?
AID  - 10.14444/8100
DP  - 2021 Aug 01
TA  - International Journal of Spine Surgery
PG  - 780--787
VI  - 15
IP  - 4
4099  - https://www.ijssurgery.com/content/15/4/780.short
4100  - https://www.ijssurgery.com/content/15/4/780.full
SO  - Int J Spine Surg2021 Aug 01; 15
AB  - Background: Currently, few studies have examined whether patients with back or leg pain-predominant symptoms fare better clinically after lumbar spine surgery; therefore, the purpose of this study was to determine whether patients with back pain-dominant symptoms improved to a similar degree as patients with mixed or leg pain-dominant symptoms after lumbar surgery.Methods: A retrospective cohort study was conducted at a single academic center, in which patients were stratified into three groups: (1) back pain-dominant group (B) (visual analog score [VAS] back – VAS leg ≥ 1.0 point), (2) neutral group (N) (VAS back – VAS leg < 1.0 point), or (3) leg pain-dominant group (L) (VAS leg – VAS back ≥ 1.0 point), using a VAS threshold difference of 1.0 point. As a secondary analysis, the VAS leg-to-back pain (LBR) ratio was used to further stratify patients: (1) nonleg pain-dominant (NLPD) group (LBR ≤ 1.0) or (2) leg pain-dominant (LPD) group (LBR > 1.0). Patient outcomes, including physical component score of the short form-12 survey (PCS-12), mental component score of the short form-12 survey (MCS-12), and Oswestry Disability Index (ODI), were identified and compared between groups using univariate and multivariate analysis.Results: There were no significant differences in preoperative, postoperative, or delta scores for PCS-12 or ODI scores between groups. In patients undergoing decompression surgery, those with back pain-dominant or mixed symptoms (B, N, or NLPD groups) did not improve with respect to MCS-12 scores after surgery (P > .05), and those with leg pain-dominant symptoms (LPD group) had greater delta MCS-12 scores (P = .046) and greater recovery rates (P = .035). Multiple linear regression did not find LPD to be an independent predictor of PCS-12 or ODI scores.Conclusion: Patients undergoing lumbar decompression surgery and leg pain-dominant symptoms noted a greater improvement in MCS-12 scores; however, there were no differences in PCS-12 or ODI scores.Level of Evidence: 3.Clinical Relevance: Patients undergoing lumbar decompression surgery demonstrate no major clinically significant differences when split up by pain-dominance groups.