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Effect of Fibromyalgia Symptoms on Outcome of Spinal Surgery.
Pain Med. 2017 04 01; 18(4):773-780.PM

Abstract

Objectives

To evaluate the effect of presurgical symptoms characteristic of fibromyalgia on the postsurgical outcome of patients undergoing spinal surgery.

Methods

In this observational cohort study, participants were patients scheduled for spinal surgery, including cervical or lumbar laminectomy and foraminectomy. Presurgical evaluation included physical examination and manual dolorimetry. Questionnaires included the widespread pain index (WPI), symptom severity scale (SSS), and SF-36. Postsurgical evaluation performed at 10-12 weeks included questionnaires, physical examination, and dolorimetry.

Results

Forty patients (21 male, 19 female) were recruited. Four patients (10%) fulfilled American College of Rheumatology (ACR) 1990 fibromyalgia; nine patients fulfilled 2010 criteria (22.5%). Overall, a significant 34% reduction in WPI was observed postsurgically (P < 0.01), but no significant change was observed in SSS. Comparing outcomes for patients fulfilling and not fulfilling fibromyalgia criteria, fibromyalgia syndrome (FMS)-negative patients experienced highly significant reductions of both SSS and WPI (-50.1% and -42.9%, respectively, P < 0.01), while FMS-positive patients experienced no reduction of SSS symptoms and only a marginally significant reduction in WPI (-20.3%, P = 0.04). A significant negative correlation was observed between results of presurgical WPI and change in physical role functioning SF-36 component postsurgically. A significant negative correlation was observed between presurgical SSS and change in composite physical functioning SF-36 component. Regression analysis demonstrated a difference in trend between FMS-positive and FMS-negative patients regarding postop changes in SSS, as well as a difference in trend regarding the general health role limitation due to emotional problems and pain components of the SF-36.

Conclusions

Fibromyalgia symptoms were highly prevalent among patients scheduled for spinal surgery. A negative correlation was observed between presurgical severity of fibromyalgia symptoms and components of postsurgical SF-36. Patients with symptoms typical of fibromyalgia may have a less favorable outcome after spinal surgery. The clinical utility of surgical intervention in such patients should be carefully evaluated, and treatment specific for fibromyalgia might be considered before embarking on a surgical course.

Authors+Show Affiliations

Institute of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.Institute of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.Institute of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.Department of Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.Department of Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.Department of Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Pub Type(s)

Clinical Trial
Journal Article
Observational Study

Language

eng

PubMed ID

28339521

Citation

Ablin, Jacob N., et al. "Effect of Fibromyalgia Symptoms On Outcome of Spinal Surgery." Pain Medicine (Malden, Mass.), vol. 18, no. 4, 2017, pp. 773-780.
Ablin JN, Berman M, Aloush V, et al. Effect of Fibromyalgia Symptoms on Outcome of Spinal Surgery. Pain Med. 2017;18(4):773-780.
Ablin, J. N., Berman, M., Aloush, V., Regev, G., Salame, K., Buskila, D., & Lidar, Z. (2017). Effect of Fibromyalgia Symptoms on Outcome of Spinal Surgery. Pain Medicine (Malden, Mass.), 18(4), 773-780. https://doi.org/10.1093/pm/pnw232
Ablin JN, et al. Effect of Fibromyalgia Symptoms On Outcome of Spinal Surgery. Pain Med. 2017 04 1;18(4):773-780. PubMed PMID: 28339521.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of Fibromyalgia Symptoms on Outcome of Spinal Surgery. AU - Ablin,Jacob N, AU - Berman,Mark, AU - Aloush,Valerie, AU - Regev,Gilad, AU - Salame,Khalil, AU - Buskila,Dan, AU - Lidar,Zvi, PY - 2016/1/1/pubmed PY - 2018/3/22/medline PY - 2017/3/25/entrez KW - Fibromyalgia KW - Presurgical Evaluation KW - Spinal Surgery SP - 773 EP - 780 JF - Pain medicine (Malden, Mass.) JO - Pain Med VL - 18 IS - 4 N2 - Objectives: To evaluate the effect of presurgical symptoms characteristic of fibromyalgia on the postsurgical outcome of patients undergoing spinal surgery. Methods: In this observational cohort study, participants were patients scheduled for spinal surgery, including cervical or lumbar laminectomy and foraminectomy. Presurgical evaluation included physical examination and manual dolorimetry. Questionnaires included the widespread pain index (WPI), symptom severity scale (SSS), and SF-36. Postsurgical evaluation performed at 10-12 weeks included questionnaires, physical examination, and dolorimetry. Results: Forty patients (21 male, 19 female) were recruited. Four patients (10%) fulfilled American College of Rheumatology (ACR) 1990 fibromyalgia; nine patients fulfilled 2010 criteria (22.5%). Overall, a significant 34% reduction in WPI was observed postsurgically (P < 0.01), but no significant change was observed in SSS. Comparing outcomes for patients fulfilling and not fulfilling fibromyalgia criteria, fibromyalgia syndrome (FMS)-negative patients experienced highly significant reductions of both SSS and WPI (-50.1% and -42.9%, respectively, P < 0.01), while FMS-positive patients experienced no reduction of SSS symptoms and only a marginally significant reduction in WPI (-20.3%, P = 0.04). A significant negative correlation was observed between results of presurgical WPI and change in physical role functioning SF-36 component postsurgically. A significant negative correlation was observed between presurgical SSS and change in composite physical functioning SF-36 component. Regression analysis demonstrated a difference in trend between FMS-positive and FMS-negative patients regarding postop changes in SSS, as well as a difference in trend regarding the general health role limitation due to emotional problems and pain components of the SF-36. Conclusions: Fibromyalgia symptoms were highly prevalent among patients scheduled for spinal surgery. A negative correlation was observed between presurgical severity of fibromyalgia symptoms and components of postsurgical SF-36. Patients with symptoms typical of fibromyalgia may have a less favorable outcome after spinal surgery. The clinical utility of surgical intervention in such patients should be carefully evaluated, and treatment specific for fibromyalgia might be considered before embarking on a surgical course. SN - 1526-4637 UR - https://www.unboundmedicine.com/medline/citation/28339521/Effect_of_Fibromyalgia_Symptoms_on_Outcome_of_Spinal_Surgery_ L2 - https://academic.oup.com/painmedicine/article-lookup/doi/10.1093/pm/pnw232 DB - PRIME DP - Unbound Medicine ER -