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Predictors of Surgical Outcome

  • Chapter
Spinal Disorders

Abstract

A not inconsiderable proportion of patients operated on for spinal disorders will have a poor result (Table 1), regardless of the apparent technical success of the operative procedure itself. In a large randomized controlled trial of fusion methods for chronic low back pain (posterolateral vs posterolateral with screws and internal fixation vs posterolateral with screws and interbody fusion), the proportions of patients achieving solid fusion were 72%, 87% and 91% in each group respectively; however, these were unrelated to the patients’ ratings of global outcome and changes in pain and function, which were highly comparable between the groups [25] Patient-orientated and radiological outcomes were similarly uncorrelated in a large study of the long-term results of patients undergoing posterior spondylodesis for spondylolysis and spondylolisthesis [52]. In a study of 78 patients with adolescent idiopathic scoliosis who had undergone surgery with Harrington instrumentation 20 years previously, the overall long-term clinical outcome (assesed with the Scoliosis Research Society questionnaire) showed no correlation with the radiological outcome [39]. Finally, in a large follow-up study of patients with lumbar spinal stenosis, successful or unsuccessful surgical decompression (judged by the postoperative observation of stenosis on CT) did not correlate with patients’ subjective disability, walking capacity or severity of pain [40].

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References

  1. Amundsen T, Weber H, Nordal HJ, Magnaes B., Abdelnoor M, Lilleas F (2000) Lumbar spinal stenosis: conservative or surgical management? A prospective 10-year study. Spine 25 11: 1424–1435; discussion 1435–1426

    Article  PubMed  CAS  Google Scholar 

  2. Andersen T, Christensen FB, Laursen M, Hoy K, Hansen ES, Bunger C (2001) Smoking as a predictor of negative outcome in lumbar spinal fusion. Spine 26 23:2623–2628

    Article  PubMed  CAS  Google Scholar 

  3. Asch HL, Lewis PJ, Moreland DB, Egnatchik JG, Yu YJ, Clabeaux DE, Hyland AH (2002) Prospective multiple outcomes study of out patient lumbar microdiscectomy: should 75 to 80% success rates be the norm? J Neurosurg Spine 96 (1 Suppl):34–44

    Article  Google Scholar 

  4. Bernd L, Schiltenwolf M, Mau H, Schindele S (1997) No indications for percutaneous lumbar discectomy? Int Orthop 21 3: 164–168

    Article  PubMed  CAS  Google Scholar 

  5. Birkmeyer NJ, Weinstein JN, Tosteson AN, Tosteson TD, Skinner JS, Lurie JD, Deyo R, Wennberg JE (2002) Design of the Spine Patient Outcomes Research Trial (SPORT). Spine 27 12: 1361–1372

    Article  PubMed  Google Scholar 

  6. Block AR, Ohnmeiss DD, Guyer RD, Rashbaum RF, Hochschuler SH (2001) The use of presurgical psychological screening to predict the outcome of spine surgery. Spine J 1 4: 274–282

    Article  PubMed  CAS  Google Scholar 

  7. Bombardier C (2000) Outcome assessments in the evaluation of treatment of spinal disorders. Spine 25 24:3100–3103

    Article  PubMed  CAS  Google Scholar 

  8. Bombardier C, Hayden J, Beaton DE (2001) Minimal Clinically Important Difference. Low Back Pain: Outcome Measures. Pain 28:431–438

    CAS  Google Scholar 

  9. Brox JI, Sorensen R, Friis A, Nygaard O, Indahl A, Keller A, Ingebrigtsen T, Eriksen HR, Holm I, Koller AK, Riise R, Reikeras O (2003) Randomized clinical trial of lumbar instrumented fusion and cognitive intervention and exercises in patients with chronic low back pain and disc degeneration. Spine 28 17:1913–1921

    Article  PubMed  Google Scholar 

  10. Buttermann GR, Garvey TA, Hunt AF, Transfeldt EE, Bradford DS, Boachie-Adjei O, Ogilvie JW (1998) Lumbar fusion results related to diagnosis. Spine 23 1:116–127

    Article  PubMed  CAS  Google Scholar 

  11. Carragee EJ (2001) Psychological screening in the surgical treatment of lumbar discherniation. Clin J Pain 17 3:215–219

    Article  PubMed  CAS  Google Scholar 

  12. Carragec EJ, Han MY, Suen PW, Kim D (2003) Clinical outcomes after lumbar discectomy for sciatica: the effects of fragment type and anular competence. J Bone Joint Surg Am 85-A 1: 102–108

    Google Scholar 

  13. Carragee EJ, Kim DH (1997) A prospective analysis of magnetic resonance imaging findings in patients with sciatica and lumbar disc herniation. Correlation of outcomes with disc fragment and canal morphology. Spine 22 14: 1650–1660

    Article  PubMed  CAS  Google Scholar 

  14. Coste J, Deleco euillerie G, Cohen de Lara A, Le Parc JM, Paolaggi JB (1994) Clinical course and prognostic factors in acute low back pain: an inception cohort study in primary care practice. BMJ 308:577–580

    Google Scholar 

  15. DeBerard MS, Masters KS, Colledge AL, Holmes EB (2003) Presurgical biopsychosocial variables predict medical and compensation costs of lumbar fusion in Utah workers’ compensation patients. Spine J 3 6:420–429

    Article  PubMed  Google Scholar 

  16. DeBerard MS, Masters KS, Colledge AL, Schleusener RL, Schlegel JD (2001) Outcomes of posterolateral lumbarfusion in Utah patients receiving workers’ compensation: a retrospective cohort study. Spine 26 7:738–746; discussion 747

    Article  PubMed  CAS  Google Scholar 

  17. Deyo R, Centor RM (1986) Assessing the responsiveness of functional scales to clinical change: an analogy to diagnostic test performance. J Chron Dis 11:897–906

    Article  Google Scholar 

  18. Deyo RA, Battie M, Beurskens AJHM, Bombardier C, Croft P, Koes B, Malmivaara A, Roland M, Von Korff M, Waddell G (1998) Outcome measures for low back pain research. A proposal for standardized use. Spine 23 18:2003–2013

    Article  PubMed  CAS  Google Scholar 

  19. Dionne CE, Von Korff M, Koepsell TD, Deyo RA, Barlow WE, Checkoway H (1999) A comparison of pain, functional limitations, and work status indices as outcome measures in back pain research. Spine 24 22:2339–2345

    Article  PubMed  CAS  Google Scholar 

  20. Elfering A (2006) Work-related outcome assessment instruments. Eur Spine J 15 Suppl 1:S32–43

    Article  Google Scholar 

  21. Elfering A, Mannion AF (2006) Epidemiology and risk factors for spinal disorders. Chapter 6, this volume

    Google Scholar 

  22. Epker J, Block AR (2001) Presurgical psychological screening in back pain patients: a review. Clin J Pain 17 3:200–205

    Article  PubMed  CAS  Google Scholar 

  23. Fairbank J, Frosh H, Wilson-MacDonald J, Yu LM, Barker KL, Collins R (2005) A randomised controlled trial to compare surgical stabilisation of the lumbar spine with an intensive rehabilitation programme for patients with chronic low back pain: the MRC spine stabilisation trial. BMJ 330:1233

    Article  PubMed  Google Scholar 

  24. Franklin GM, Haug J, Heyer NJ, McKeefrey SP, Picciano JF (1994) Outcome of lumbar fusion in Washington State workers’ compensation. Spine 19 17:1897–1903; discussion 1904

    Article  PubMed  CAS  Google Scholar 

  25. Fritzell P, Hägg O, Wessberg P, Nordwall A (2002) Chronic low back pain and fusion: a comparison of three surgical techniques: a prospective multicenter randomized study from the Swedish lumbar spine study group. Spine 27 11:1131–1141

    Article  PubMed  Google Scholar 

  26. Glassman SD, Anagnost SC, Parker A, Burke D, Johnson JR, Dimar JR (2000) The effect of cigarette smoking and smoking cessation on spinal fusion. Spine 25 20:2608–2615

    Article  PubMed  CAS  Google Scholar 

  27. Glassman SD, Dimar JR, Johnson JR, Minkow R (1998) Preoperative SF-36 responses as a predictor of reoperation following lumbar fusion. Orthopedics 21 11:1201–1203

    PubMed  CAS  Google Scholar 

  28. Grebner M, Breme K, Rothoerl R, Woertgen C, Hartmann A, Thome C (1999) Coping and convalescence course after lumbar disk operations]. Schmerz 13 1:19–30

    Article  PubMed  CAS  Google Scholar 

  29. Greenough CG (2006) Outcome assessment: recommendations for daily practice. Eur Spine 115 Suppl 1:S118–123

    Article  Google Scholar 

  30. Greenough CG, Peterson MD, Hadlow S, Fraser RD (1998) Instrumented posterolateral lumbar fusion. Results and comparison with anterior interbody fusion. Spine 23 4:479–486

    Article  PubMed  CAS  Google Scholar 

  31. Greenough CG, Taylor LJ, Fraser RD (1994) Anterior lumbar fusion. A comparison of noncompensation patients with compensation patients. Clin Orthop 300:30–37

    PubMed  Google Scholar 

  32. Greenough CG, Taylor LJ, Fraser RD (1994) Anterior lumbar fusion: results, assessment techniques and prognostic factors. Eur Spine 3 4:225–230

    Article  CAS  Google Scholar 

  33. Grob D, Benini A, Junge A, Mannion AF (2005) Clinical experience with the Dynesys semirigid fixation system for the lumbar spine: surgical and patient-orientated outcome in 50 cases after an average of 2 years. Spine 30 3:324–331

    Article  PubMed  Google Scholar 

  34. Gunzburg R, Keller TS, Szpalski M, Vandeputte K, Spratt KF (2003) Clinical and psychofunctional measures of conservative decompression surgery for lumbar spinal stenosis: a prospective cohort study. Eur Spine J 12 2:197–204

    PubMed  CAS  Google Scholar 

  35. Hagg A, Fritzell P, O den A, Nordwall A (2002) Simplifying outcome measurement: evaluation of instruments for measuring out come after fusion surgery for chronic low back pain. Spine 27 11:1213–1222

    Google Scholar 

  36. Hagg O, Fritzell P, Ekselius L, Nordwall A (2003) Predictors of outcome in fusion surgery for chronic low back pain. A report from the Swedish Lumbar Spine Study. Eur Spine J 12 1: 22–33

    PubMed  CAS  Google Scholar 

  37. Hagg O, Fritzell P, Hedlund R, Moller H, Ekselius L, Nordwall A (2003) Pain-drawing does not predict the outcome of fusion surgery for chronic low-back pain: a report from the Swedish Lumbar Spine Study. Eur Epine J 12:2–11

    CAS  Google Scholar 

  38. Hagg O, Fritzell P, Nordwall A, Group SLSS (2003) The clinical importance of changes in outcome scores after treatment for chronic low back pain. Eur Spine J 12 1:12–20

    PubMed  CAS  Google Scholar 

  39. Helenius I, Remes V, Yrjonen T, Ylikoski M, Schlenzka D, Helenius M, Poussa M (2002) Comparison of long-term functional and radiologic outcomes after Harrington instrumentation and spondylodesis in a dolescent idiopathic scoliosis: a review of 78 patients. Spine 27 2: 176–180

    Article  PubMed  Google Scholar 

  40. Herno A (1995) Surgical results of lumbar spinal stenosis. Ann Chir Gynaecol Suppl 210: 1–969

    PubMed  CAS  Google Scholar 

  41. Hiebert R, Nordin M (2006) Methodological aspects of outcomes research. Eur Spine J 15 Suppl 1:S4–16

    Article  Google Scholar 

  42. Hobby IL, Lutchman LN, Powell JM, Sharp DJ (2001) The distress and risk assessment method (DRAM). J Bone Joint Surg Br 83 1:19–21

    Article  PubMed  CAS  Google Scholar 

  43. Howe J, Frymoyer JW (1985) The effects of questionnaire design on the determination of end results in lumbar spinal surgery. Spine 10 9:804–805

    Article  PubMed  CAS  Google Scholar 

  44. Iguchi T, Kurihara A, Nakayama J, Sato K, Kurosaka M, Yamasaki K (2000) Minimum 10-year outcome of decompressive laminectomy for degenerative lumbar spinal stenosis. Spine 25 14:1754–1759

    Article  PubMed  CAS  Google Scholar 

  45. Junge A, Dvorak J, Ahrens S (1995) Predictors of bad and good outcomes of lumbar disc surgery. A prospective clinical study with recommendations for screening to avoid bad outcomes. Spine 20 4:460–468

    Article  PubMed  CAS  Google Scholar 

  46. Junge A, Frohlich M, Ahrens S, Hasenbring M, Sandler A, Grob D, Dvorak J (1996) Predictors of bad and good outcome of lumbar spine surgery: A prospective clinical study with 2 years’ follow up. Spine 21 9:1056–1064; discussion 1064–1055.

    Article  PubMed  CAS  Google Scholar 

  47. Kaptain GJ, Shaffrey CI, Alden TD, Young JN, Laws ER, Jr., Whitehill R (1999) Secondary gain influences the outcome of lumbar but not cervical disc surgery. Surg Neurol 52 3: 217–223; discussion 223–215

    Article  PubMed  CAS  Google Scholar 

  48. Katz JN, Stucki G, Lipson SJ, Fossel AH, Grobler LJ, Weinstein JN (1999) Predictors of surgical outcome in degenerative lumbar spinal stenosis. Spine 24 21:2229–2233

    Article  PubMed  CAS  Google Scholar 

  49. Keller KB, Atlas SJ, Soule DN, Singer DE, Deyo RA (1999) Relationship between rates and outcomes of operative treatment for lumbar disc her niation and spinal stenosis. J Bone Joint Surg Am 81 6:752–762

    PubMed  CAS  Google Scholar 

  50. Kohlboeck G, Greimel KV, Piotrowski WP, Leibetseder M, Krombholz-Reindl M, Neuhofer R, Schmid A, Klinger R (2004) Prognosis of multifactorial outcome in lumbar discectomy: a prospective longitudinal study investigating patients with disc prolapse. Clin J Pain 20 6:455–461

    Article  PubMed  Google Scholar 

  51. Lacaille RA, Deberard MS, Masters KS, Colledge AL, Bacon W (2005) Presurgical biopsy chosocial factors predict multidimensional patient: outcomes of interbody cage lumbar fusion. Spine J 5 1:71–78

    Article  PubMed  Google Scholar 

  52. Lamberg TS, Remes VM, Helenius IJ, Schlenzka DK, Yrjonen TA, Osterman KE, Tervahartiala PO, Seitsalo SK, Poussa MS (2005) Long-term clinical, functional and radiological outcome 21 years after posterior or posterolateral fusion in childhood and adolescence isthmic spondylolisthesis. Eur Spine J 14 7:639–644

    Article  PubMed  Google Scholar 

  53. Little DG, MacDonald D (1994) The use of the percentage change in Oswestry Disability Index score as an outcome measure in lumbar spinal surgery. Spine 19 19:2139–2143

    Article  PubMed  CAS  Google Scholar 

  54. Loupasis GA, Stamos K, Katonis PG, Sapkas G, Korres DS, Hartofilakidis G (1999) Seven-to 20-year outcome of lumbar discectomy. Spine 24 22:2313–2317

    Article  PubMed  CAS  Google Scholar 

  55. Lutz GK, Butzlaff ME, Atlas SJ, Keller RB, Singer DE, Deyo RA (1999) The relation between expectations and outcomes in surgery for sciatica. J Gen Intern Med 14 12:740–744

    Article  PubMed  CAS  Google Scholar 

  56. Main CJ, Spanswick CC (1995) Personality assessment and the Minnesota Multiphasic Personality inventory, 50 years on: do we still need our security blanket? Pain Forum 4:90–96

    Google Scholar 

  57. Mannion AF, Dvorak J, Junge A, Porchet F, Grob D (2004) Do retrospective ratings of “global outcome” reflect prospective changes in pain and self-rated disability after spine surgery? 64. Jahreskongress der schweizerischen Gesellschaft für Orthopädie. Lausanne, Switzerland

    Google Scholar 

  58. Mannion AF, Alfering A (2006) Predictors of surgical outcome and their assessment. Eur Spine J 15 Suppl 1:S93–108

    Article  Google Scholar 

  59. Mannion AF, Elfering A, Staerkle R, Junge A, Grob D, Semmer NK, Jacobshagen N, Dvorak J, Boos N (2005) Outcome assessment in low back pain: how low can you go: Eur Spine J 14 10:1014–1026

    Article  PubMed  Google Scholar 

  60. Mannion AF, Junge A, Dvorak J, Porchet F, Müntener M, Grob D (2005) Does how well you do depend on how well you think you’ll do? A prospective study of expectations in patients undergoing spinal decompression surgery Spine Society of Europe. Barcelona, Spain 14:S17

    Google Scholar 

  61. Mannion AF, Junge A, Grob D, Dvorak J, Fairbank JCT (2006) Development of a German version of the Oswestry Low Back Index. Part 2: sensitivity to change after spinal surgery. Eur Spine J 15:66–73

    Article  PubMed  CAS  Google Scholar 

  62. Mannion AF, Junge A, Porchet F, Jeszenszky D, Bartanusz V, Kleinstück F, Dvorak J, Grob D (2005) Responsiveness of a short set of core outcome measures in spinal surgery patients: a prospective study. International Society for the Study of the Lumbar Spine. New York, USA

    Google Scholar 

  63. McGregor AH, Hughes SP (2002) The evaluation of the surgical management of nerve root compression in patients with low back pain: Part 1: the assessment of outcome. Spine 27 13: 1465–1470

    Article  PubMed  Google Scholar 

  64. McGregor AH, Hughes SP (2002) The evaluation of the surgical management of nerve root compression in patients with low back pain: Part 2: patient expectations and satisfaction. Spine 27 13:1471–1476; discussion 1476–1477

    Article  PubMed  Google Scholar 

  65. Muller U, Roeder C, Dubs L, Duetz MS, Greenough CG (2004) Condition-specific outcome measures for low back pain. Part II: Scale construction. Eur Spine J 13:314–324

    PubMed  CAS  Google Scholar 

  66. Ng LC, Sell P (2004) Predictive value of the duration of sciatica for lumbar discectomy. A prospective cohort study. J Bone Joint Surg Br 86 4:546–549

    PubMed  CAS  Google Scholar 

  67. North RB, Campbell JN, James CS, Conover-Walker MK, Wang H, Piantadosi S, Rybock JD, Long DM (1991) Failed back surgery syndrome: 5-year follow-up in 102 patients undergoing repeated operation. Neurosurgery 28 5:685–690; discussion 690–681

    Article  PubMed  CAS  Google Scholar 

  68. Nygaard OP, Kloster R, Solberg T (2000) Duration of leg pain as a predictor of outcome after surgery for lumbar discherniation: a prospective cohort study with 1-year follow up. J Neurosurg Spine 92:131–134

    CAS  Google Scholar 

  69. Penta M, Fraser RD (1997) Anterior lumbar interbody fusion. A minimum 10-year followup. Spine 22 20:2429–2434

    Article  PubMed  CAS  Google Scholar 

  70. Peolsson A, Hedlund R, Vavruch L (2004) Prediction of fusion and importance of radiological variables for the outcome of anterior cervical decompression and fusion. Eur Spine J 13 3:329–234

    Article  Google Scholar 

  71. Peolsson A, Hedlund R, Vavruch L, Oberg B (2003) Predictive factors for the outcome of anterior cervical decompression and fusion. Eur Spine J 12 3:274–280

    PubMed  Google Scholar 

  72. Rotheorl RD, Woertgen C, Brawanski A (2002) When should conservative treatment for lumbar disc herniation be ceased and surgery considered. Neurosurg Rev 25 3:162–165

    Article  Google Scholar 

  73. Schade V, Semmer N, Main CJ, Hora J, Boos N (1999) The impact of clinical, morphological, psychosocial and work-related factors on the outcome of lumbar discectomy. Pain 80 1–2:239–249

    Article  PubMed  CAS  Google Scholar 

  74. Solberg TK, Nygaard OP, Sjaavik K, Hofoss D, Ingebrigtsen T (2005) The risk of “getting worse” after lumbar microdiscectomy. Eur Spine J 14 1:49–54

    Article  PubMed  Google Scholar 

  75. Spengler DM, Ouellette EA, Battie M, Zeh J (1990) Elective discectomy for herniation of a lumbar disc. Additional experience with an objective method. J Bone Joint Surg Am 72 2:230–237

    PubMed  CAS  Google Scholar 

  76. Spratt KF, Keller TS, Szpalski M, Vandeputte K, Gunzburg R (2004) A predictive model for outcome after conservative decompression surgery for lumbar spinal stenosis. Eur Spine J 13 1:14–21

    Article  PubMed  CAS  Google Scholar 

  77. Staerkle R, Mannion AF, Elfering A, Junge A, Semmer NK, Jacobshagen N, Grob D, Dvorak I, Boos N (2004) Longitudinal validation of the fear-avoidance beliefs questionnaire (FABQ) in a Swiss-German sample of low back pain patients. Eur Spine J 13 4:332–340

    Article  PubMed  Google Scholar 

  78. Stärkle R, Mannion AF, Junge A, Elfering A, Grob D, Dvorak J, Boos N (2002) The influence of baseline psychological factors on outcome after spine surgery. SIROT. San Diego, USA

    Google Scholar 

  79. Stromqvist B (2002) Evidence-based lumbar spine surgery. The role of national registration. Acta Orthop Scand Suppl 73 305:34–39

    PubMed  Google Scholar 

  80. Stromqvist B, Fritzell P, Hagg O, Jonsson B (2005) One-year report from the Swedish National Spine Register, Swedish Society of Spinal Surgeons. Acta Orthop Suppl 76 319:1–24

    Article  PubMed  Google Scholar 

  81. Stromqvist B, Jonsson B, Fritzell P, Hagg O, Larsson BE, Lind B (2001) The Swedish National Register for lumbar spine surgery: Swedish Society for Spinal Surgery. Acta Orthop Scand 72 2:99–106

    Article  PubMed  CAS  Google Scholar 

  82. Sun EC, Wang JC, Endow K, Delamarter RB (2004) Adjacent two-level lumbar discectomy: outcome and SF-36 functional assessment. Spine 29 2:E22–27

    Article  PubMed  Google Scholar 

  83. Tandon V, Campbell F, Ross ER (1999) Posterior lumbar interbody fusion. Association between disability and psychological disturbance in noncompensation patients. Spine 24 17:1833–1838

    Article  PubMed  CAS  Google Scholar 

  84. Trief PM, Grant W, Fredrickson B (2000) A prospective study of psychological predictors of lumbar surgery outcome. Spine 25 20:2616–2621

    Article  PubMed  CAS  Google Scholar 

  85. Uomoto JM, Turner JA, Herron LD (1988) Use of the MMPI and MCMI in predicting out-come of lumbar laminectomy. J Clin Psychol 44 2:191–197

    Article  PubMed  CAS  Google Scholar 

  86. Vaccaro AR, Ring D, Scuderi G, Cohen DS, Garfin SR (1997) Predictors of outcome in patients with chronic back pain and low-grade spondylolisthesis Spine 22 17:2030–2034; discussion 2035

    Article  PubMed  CAS  Google Scholar 

  87. Van Susante J, Van de Schaaf D, Pavlov P (1998) Psychological distress deteriorates the subjective outcome of lumbosacral fusion. A prospective study. Acta Orthop Belg 64 4:371–377

    PubMed  Google Scholar 

  88. Waddell G, Morris EW, Di Paola MP, Bircher M, Finlayson D (1986) A concept of illness tested as an improved basis for surgical decisions in low-back disorders. Spine 11 7:712–719

    Article  PubMed  CAS  Google Scholar 

  89. Wetzel FT, McCracken L, Robbins RA, Lahey DM, Carnegie M, Phips FM (2001) Temporal stability of the Minnesota Multiphasic Personality Inventory (MMPI) in patients undergoing lumbar fusion: a poor predictor of surgical outcome. Am J Orthop 30 6:469–474

    PubMed  CAS  Google Scholar 

  90. Woertgen C, Rothoerl RD, Breme K, Altmeppen J, Holzschuh M, Brawanski A (1999) Variability of outcome after lumbar disc surgery. Spine 24 8:807–811

    Article  PubMed  CAS  Google Scholar 

  91. Young JN, Shaffrey CI, Laws ER, Jr., Lovell LR (1997) Lumbar disc surgery in a fixed compensation population: a model for influence of secondary gain on surgical outcome. Surg Neurol 48 6:552–558; discussion 558–559

    Article  PubMed  CAS  Google Scholar 

  92. Zanoli G, Stromqvist B, Padua R, Romanini E (2000) Lessons learned searching for a HRQoL instrument to assess the results of treatment in persons with lumbar disorders. Spine 25 24:3178–3185

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Wirbelsäulenzentrum, Schulthessklinik, Lengghalde 2, 808, Zürich, Schweiz

    Anne F. Mannion

  2. Psychologisches Institut, Universität Bern, Muesmattstr. 43, 3000, Bern 9, Schweiz

    Achim Elfering

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  1. Anne F. Mannion
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  1. Zentrum für Wirbelsäulen- und Rückenmarkchirurgie, Universität Zürich Universitätsklinik Balgrist, Forchstraße 340, 8008, Zürich, Switzerland

    Norbert Boos

  2. Institut für Evaluative Forschung in Orthopädischer Chirurgie MEM Forschungszentrum, Universität Bern, Stauffacherstraße 78, 3014, Bern, Switzerland

    Max Aebi

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Mannion, A.F., Elfering, A. (2008). Predictors of Surgical Outcome. In: Boos, N., Aebi, M. (eds) Spinal Disorders. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-69091-7_7

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