Table 1.
Prognostic factor | Clinical setting | Country | Duration of symptoms† | Followup | Conflicting studies?ǂ | Supporting studies? |
---|---|---|---|---|---|---|
Predictors of treatment failure defined as subsequent surgery | ||||||
Initial leg pain intensity [30] | Primary care | Netherlands | Acute | 6 months | No | Yes [20] |
Initial disability [20] | Specialty care | Netherlands | Subacute | 1 year | No | No |
Duration of symptoms [28] | Specialty care | France | Acute | 11–24 months | Yes [30] | No |
Prior low back pain [30] | Primary care | Netherlands | Acute | 6 months | No | No |
Positive straight leg raise test (SLR) [28] | Specialty care | France | Acute | 11–24 months | Yes [20, 30] | Yes [31]§ |
Positive crossed SLR [30] | Primary care | Netherlands | Acute | 6 months | No | No |
Positive femoral stretch test [30] | Primary care | Netherlands | Acute | 6 months | No | Yes [31]§ |
Predictors of treatment failure defined as persistent leg pain at followup | ||||||
Initial leg pain intensity [11] | Specialty care | Norway | Acute/chronic | 1–2 years | Yes [27] | No |
Initial back pain intensity [11] | Specialty care | Norway | Acute/chronic | 1–2 years | No | No |
Female sex [12] | Specialty care | Denmark | Acute/chronic | 14 months | Yes [17, 27] | No |
Duration of symptoms [23] | Specialty care | United States | Subacute/chronic | 2–4 years | Yes [11] | No |
Smoking [11] | Specialty care | Norway | Acute/chronic | 1–2 years | Yes [17] | No |
Medical comorbidities [11] | Specialty care | Norway | Acute/chronic | 1–2 years | No | No |
Workers compensation [3] | Specialty care | United States | Acute/chronic | 4 years | Yes [4] | Yes [2] |
Muscle weakness (any) [11] | Specialty care | Norway | Acute/chronic | 1–2 years | No | No |
Herniation morphology [12]|| | Specialty care | Denmark | Acute/chronic | 14 months | No | No |
Predictors of treatment failure defined as persistent disability at followup | ||||||
Initial disability [11] | Specialty care | Norway | Acute/chronic | 1–2 years | No | No |
Initial back pain intensity [11] | Specialty care | Norway | Acute/chronic | 1–2 years | No | No |
Female sex [12] | Specialty care | Denmark | Acute/chronic | 2 years | No | No |
Duration of symptoms [23] | Specialty care | United States | Subacute/ chronic | 2–4 years | No | Yes [11] |
Smoking [11] | Specialty care | Norway | Acute/chronic | 1–2 years | No | No |
Medical comorbidities [11] | Specialty care | Norway | Acute/chronic | 1–2 years | No | No |
Prior low back pain [11] | Specialty care | Norway | Acute/chronic | 2–4 years | No | No |
Workers compensation [3] | Specialty care | United States | Acute/chronic | 4 years, | Yes [4] | Yes [2] |
Herniation morphology [12]|| | Specialty care | Denmark | Acute/chronic | 14 months | No | No |
Abnormal tendon reflexes [11] | Specialty care | Norway | Acute/chronic | 1–2 years | No | No |
Predictors of treatment failure defined as participant-reported lack of recovery at followup | ||||||
Age [14] | Specialty care | Netherlands | Subacute | 5 year | Yes [21, 31] | No |
Female sex [21] | Specialty care | Netherlands | Subacute | 1 year | Yes [31] | No |
Duration of symptoms [31] | Primary care | Netherlands | Acute | 3 months | No | No |
Smoking [21] | Specialty care | Netherlands | Subacute | 1 year | Yes [31] | No |
Workers compensation [3] | Specialty care | United States | Acute/chronic | 5–10 years | No | No |
Positive SLR [31] | Primary care | Netherlands | Acute | 3 months | Yes [21] | No |
Positive femoral stretch test [31] | Primary care | Netherlands | Acute | 3 months | No | No |
Foraminal herniation [33] | Primary care | Netherlands | Acute | 3 months | No | No |
* All associations between candidate predictors and outcomes refer to positive associations, except for those studies cited under Conflicting studies; †acute signifies duration of symptoms ≤ 12 weeks, whereas subacute signifies duration of 6–12 weeks; ǂConflicting studies refers to those in which no statistically significant association with an outcome was found or where a statistically significant association was found with a negative association (in the opposite direction than expected); §subsequent surgery was also included in a composite outcome; ||disc extrusions predicted lower pain intensity and disability; sequestrations and extrusions were collinear.