Objective: The primary objective is to characterize patients presenting to a multidisciplinary spine center to understand sociodemographic features, pain characteristics, and functional status across diagnoses. The secondary objective is to identify factors associated with worse outcomes in radiculopathy patients.
Methods: In this retrospective, registry-based cohort study, we extracted questionnaire and EHR data for 10,069 patients. Baseline sociodemographic, clinical, and pain-related were examined across the top 10 diagnostic categories. Thereafter, we performed an analysis of radiculopathy patients (n = 653) using GLMM with random intercepts to identify baseline factors associated with changes in NRS and PROMIS-PI.
Results: At presentation, patients had moderate pain intensity (mean NRS:5.1, SD:2.1), significant impairment in PROMIS-PI (mean:64.6, SD:7.9), and PROMIS-PF (mean:37.7, SD:8.9), regardless of the diagnosis. Longitudinal analysis of radiculopathy patients identified multiple statistically significant factors (p < 0.05) associated with worse outcomes, including sleep interference, depression/anxiety, smoking, BMI, and being female, Black/African American, or Asian race.
Conclusions: This study explores predictors of poor outcomes that may identify opportunities for interventions targeting modifiable risk factors and highlights the need for further research into how health disparities influence treatment outcomes. Identifying non-responders could improve selecting effective treatments through precision care, ultimately reducing costs and disability associated with chronic pain.
Keywords: Multidisciplinary spine; PROMIS; characterizing patients; chronic pain; low back pain; outcomes.
This study looked at people seeking care at a multidisciplinary spine center to better understand who they are, how much pain they have, and how pain affects their daily lives. The researchers also wanted to identify factors linked to worse outcomes among patients with radiculopathy (pain that travels from the spine into the arms or legs). Using medical records and patient questionnaires, the study included over 10,000 patients. At their first visit, most patients – regardless of their specific diagnosis – reported moderate pain levels and meaningful difficulties with physical function and daily activities. This shows that many patients arrive at specialty spine care already experiencing significant pain and disability. The researchers then focused on a subgroup of 653 patients with radiculopathy and followed their outcomes over time. Several factors were linked to worse pain and pain-related interference with daily life. These included sleep problems, symptoms of depression or anxiety, smoking, higher body weight, and certain demographic factors, including being female or identifying as Black/African American or Asian. Overall, the findings suggest that outcomes in spine-related pain are influenced not only by the medical condition itself, but also by mental health, lifestyle factors, and social and demographic differences. Addressing modifiable factors – such as sleep, mental health, smoking, and weight – may improve outcomes for some patients. The study also highlights the importance of better understanding and addressing health disparities to improve care and reduce long-term pain-related disability.