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Scoping review of early pain-related outcome domains and measurement instruments after degenerative lumbar spine surgery
  1. Ilse H van de Wijgert1,2,3,
  2. Jantina C de Groot1,2,
  3. Akkie Rood4,
  4. Maarten Spruit4,
  5. Kris C P Vissers1,2,
  6. Maaike GE Fenten1,2 and
  7. Miranda L van Hooff3,5
  1. 1Department of Anesthesiology, Sint Maartenskliniek, Nijmegen, The Netherlands
  2. 2Department of Anesthesiology, Pain and Palliative Medicine, Radboudumc, Nijmegen, The Netherlands
  3. 3Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands
  4. 4Department of Orthopaedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands
  5. 5Department of Orthopaedic Surgery, Radboudumc, Nijmegen, The Netherlands
  1. Correspondence to Ilse H van de Wijgert, Department of Anesthesiology, Sint Maartenskliniek, Nijmegen 6574 NA, Netherlands; i.vandewijgert{at}maartenskliniek.nl

Abstract

Background Optimization of perioperative pain interventions in lumbar spine surgery could reduce the incidence of acute and persistent postoperative pain and opioid consumption. Standardization in early outcome measurement provides a solid foundation for future clinical and research practices and should be integrated in core outcome sets for long-term treatment outcome evaluations. This scoping review provides an overview of outcomes used when evaluating early perioperative pain interventions after lumbar spine surgery.

Objectives To create an overview of outcome domains and measurement instruments previously used in research on perioperative pain management for degenerative lumbar spine surgery.

Evidence review A scoping review was performed to identify articles comprising outcome evaluations in adult patients who undergo degenerative lumbar spine surgery, mentioning perioperative pain interventions. 75 articles were included for review. Data on study characteristics, outcome domains and measurement instruments were extracted and structured using the three-tiered hierarchy of Porter.

Findings 12 outcome domains were identified: pain intensity (93.3%), adverse events (76%), analgesic consumption (70.7%), length of stay (52%), patient satisfaction (24%), daily functioning (22.7%), (early) mobilization (22.7%), quality of life (12%), mortality (9.3%), quality of recovery (6.7%), physical function (4%), and quality of sleep (2.7%). 63 corresponding measurement instruments were found.

Conclusions This review portrays an extensive overview of outcome measurements used in perioperative pain management in lumbar spine surgery. A lack of consensus on the set of indicators exists. This scoping review is a call for action to create consensus on how to evaluate perioperative pain interventions in degenerative lumbar spine surgery.

  • outcome assessment, health care
  • pain, postoperative
  • acute pain
  • outcomes
  • pain measurement

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Footnotes

  • Contributors According to CRediT author statement: IHvdW: conceptualization, methodology, validation, formal analysis, investigation, resources, data curation, writing—original draft, writing—review and editing, project administration. JCdG: validation, formal analysis, investigation, writing—original draft. AR: writing—original draft, writing—review and editing, supervision. MS: writing—original draft, writing—review and editing, supervision. KCPV: conceptualization, writing—original Draft, writing—review and editing, visualization, supervision. MF: conceptualization, writing—original Draft, writing—review and editing, visualization, supervision. MLvH: conceptualization, methodology, validation, formal analysis, writing—original draft, writing—review and editing, visualization, supervision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests IHvdW, JCdG, AR, CPKV, and MF declare to have no competing interests. MS declares to have a leadership role in the AOSpine Technical Commission Executive Board. MvH declares to receive grants or contracts from ZonMw ZE&GG, AOFoundation and the Scoliosis Research Society. These grants are payments to the institution.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.