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1. A Novel Multi-Dimensional Clinical Response Index Dedicated to Improving Global Assessment of Pain in Patients with Persistent Spinal Pain Syndrome after Spinal Surgery, Based on a Real-Life Prospective Multicentric Study (PREDIBACK) and Machine Learning Techniques

Author

Philippe Rigoard, Amine Ounajim, Lisa Goudman, Pierre-Yves Louis, Yousri Slaoui, Manuel Roulaud, Nicolas Naiditch, Bénédicte Bouche, Philippe Page, Bertille Lorgeoux, Sandrine Baron, Elodie Charrier, Laure Poupin, Delphine Rannou, Géraldine Brumauld de Montgazon, Brigitte Roy-Moreau, Nelly Grimaud, Nihel Adjali, Kevin Nivole, Mathilde Many, Romain David, Chantal Wood, Raphael Rigoard, Maarten Moens, and Maxime Billot

Subjects
composite score, machine learning, PSPS, failed back surgery syndrome (FBSS), chronic pain, pain intensity, Medicine
Abstract

The multidimensionality of chronic pain forces us to look beyond isolated assessment such as pain intensity, which does not consider multiple key parameters, particularly in post-operative Persistent Spinal Pain Syndrome (PSPS-T2) patients. Our ambition was to produce a novel Multi-dimensional Clinical Response Index (MCRI), including not only pain intensity but also functional capacity, anxiety-depression, quality of life and quantitative pain mapping, the objective being to achieve instantaneous assessment using machine learning techniques. Two hundred PSPS-T2 patients were enrolled in the real-life observational prospective PREDIBACK study with 12-month follow-up and received various treatments. From a multitude of questionnaires/scores, specific items were combined, as exploratory factor analyses helped to create a single composite MCRI; using pairwise correlations between measurements, it appeared to more accurately represent all pain dimensions than any previous classical score. It represented the best compromise among all existing indexes, showing the highest sensitivity/specificity related to Patient Global Impression of Change (PGIC). Novel composite indexes could help to refine pain assessment by informing the physician’s perception of patient condition on the basis of objective and holistic metrics, and also by providing new insights regarding therapy efficacy/patient outcome assessments, before ultimately being adapted to other pathologies.

Published
2021
Full Text
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2. Professional Status of Persistent Spinal Pain Syndrome Patients after Spinal Surgery (PSPS-T2): What Really Matters? A Prospective Study Introducing the Concept of 'Adapted Professional Activity' Inferred from Clinical, Psychological and Social Influence

Author

Nicolas Naiditch, Maxime Billot, Lisa Goudman, Philippe Cornet, Manuel Roulaud, Amine Ounajim, Philippe Page, Bertille Lorgeoux, Sandrine Baron, Kevin Nivole, Pierre Pries, Yassine Abdollah Moufid, Cécile Swennen, Simon Teyssedou, Tanguy Vendeuvre, Elodie Charrier, Laure Poupin, Delphine Rannou, Géraldine Brumauld de Montgazon, Pierre François Descoins, Brigitte Roy-Moreau, Nelly Grimaud, Romain David, Maarten Moens, and Philippe Rigoard

Subjects
professional status, social factors, social gradient, Failed Back Surgery Syndrome, unemployment, chronic pain, Medicine
Abstract

Persistent Spinal Pain Syndrome Type 2 (PSPS-T2) represents a main cause of work disruption. Beyond its societal consequences, occupational inactivity is responsible for a major decrease in physical/mental health in individuals but remains poorly analyzed. We designed a study to prospectively examine Professional Status (PS) evolution and its association with key bio-psychological markers. Data from 151 consecutively included working-age PSPS-T2 patients were analyzed to determine the proportion of professional inactivity and the relationships between PS and Social Gradient of Health (SGH), Numeric Pain Rating Scale (NPRS), EuroQol 5-Dimensional 5-Level (EQ-5D-5L), Oswestry Disability Index (ODI), Hospital Anxiety and Depression Scale (HADS), and Fear-Avoidance Belief Questionnaire work subscale (FABQ-W). Despite optimized medical management, 73.5% of PSPS-T2 patients remained inactive after 1 year of follow-up/p = 0.18. Inactive patients presented a low SGH/p = 0.002, higher NPRS/p = 0.048, lower EQ-5D-5L/p < 0.001, higher ODI/p = 0.018, higher HADS-D/p = 0.019 and higher FABQ-W/p < 0.001. No significant mediation effect of FABQ-W on SGH consequences regarding PS was observed in our structural model/p = 0.057. The link between unemployment and bio-psycho-social pain dimensions appears bidirectional and justifies intense collaboration with social workers. Optimizing therapeutical sequencing towards personalized professional plans implies restoring “Adapted Physical Function” as an initial goal, and tailoring an “Adapted Professional Activity”, matching with patient expectations and capabilities, as a final objective.

Published
2021
Full Text
View/download PDF

3. Persistent Spinal Pain Syndrome Type 2 (PSPS-T2), a Social Pain? Advocacy for a Social Gradient of Health Approach to Chronic Pain

Author

Nicolas Naiditch, Maxime Billot, Maarten Moens, Lisa Goudman, Philippe Cornet, David Le Breton, Manuel Roulaud, Amine Ounajim, Philippe Page, Bertille Lorgeoux, Kevin Nivole, Pierre Pries, Cecile Swennen, Simon Teyssedou, Elodie Charrier, Géraldine Brumauld de Montgazon, Pierre François Descoins, Brigitte Roy-Moreau, Nelly Grimaud, Romain David, Tanguy Vendeuvre, and Philippe Rigoard

Subjects
social gradient of health, persistent spinal pain syndrome type 2, failed back surgery syndrome, social determinants of health, Medicine
Abstract

The Social Gradient of Health (SGH), or position in the social hierarchy, is one of the major determinants of health. It influences the development and evolution of many chronic diseases. Chronic pain dramatically affects individual and social condition. Its medico-economic impact is significant and worldwide. Failed Back Surgery Syndrome or Persistent Spinal Pain Syndrome type 2 (PSPS-T2) represents one of its most fascinating and disabling conditions. However, the influence of SGH on PSPS-T2 has been poorly explored. We designed a prospective multicentric study (PREDIBACK study) to assess the SGH prevalence, and to examine its association with medical and psychological variables, in PSPS-T2 patients. This study included 200 patients to determine the SGH association with pain (NPRS), Quality of life (EQ-5D-5L), kinesiophobia (FABQ-Work), catastrophism (CSQ), and functional capacity (ODI). Around 85.3% of PSPS-T2 patients in our study had low SGH. Low SGH patients had a higher FABQ-Work and CSQ-Catastrophizing score than high SGH patients (p < 0.05). High SGH patients have a higher ODI score than low SGH patients (p < 0.10). Our results suggest that SGH is a relevant factor to guide prevention, research, and ultimately intervention in PSPS-T2 patients and could be more widely transposed to chronic pain.

Published
2021
Full Text
View/download PDF

4. O053 / #1000 A MULTIDIMENSIONAL CLINICAL RESPONSE INDEX TO IMPROVING ASSESSMENT OF PAIN IN PATIENTS WITH PERSISTENT SPINAL PAIN SYNDROME AFTER SPINAL SURGERY, A REAL-LIFE PROSPECTIVE MULTICENTRIC STUDY

Author

Maxime Billot, Philippe Rigoard, Amine Ounajim, Lisa Goudman, Pierre-Yves Louis, Yousri Slaoui, Manuel Roulaud, Nicolas Naiditch, Bénédicte Bouche, Philippe Page, Elodie Charrier, Laure Poupin, Delphine Rannou, Géraldine Brumauld De Montgazon, Aline Roy-Moreau, Nelly Grimaud, Romain David, Chantal Wood, Raphael Rigoard, Kevin Nivole, Mathilde Many, Sandrine Baron, Bertille Lorgeoux, Nihel Adjali, and Maarten Moens

Subjects
Anesthesiology and Pain Medicine, Neurology, Neurology (clinical), General Medicine
Published
2022

5. A Novel Multi-Dimensional Clinical Response Index Dedicated to Improving Global Assessment of Pain in Patients with Persistent Spinal Pain Syndrome after Spinal Surgery, Based on a Real-Life Prospective Multicentric Study (PREDIBACK) and Machine Learning Techniques

Author

Maxime Billot, Maarten Moens, Philippe Page, Amine Ounajim, Chantal Wood, Laure Poupin, Yousri Slaoui, Brigitte Roy-Moreau, Pierre-Yves Louis, Philippe Rigoard, Romain David, M. Roulaud, Nihel Adjali, Mathilde Many, Nelly Grimaud, Lisa Goudman, Delphine Rannou, Sandrine Baron, Raphael Rigoard, Géraldine Brumauld de Montgazon, Bénédicte Bouche, Elodie Charrier, Kevin Nivole, Nicolas Naiditch, Bertille Lorgeoux, Supporting clinical sciences, Neurosurgery, Pain in Motion, Neuroprotection & Neuromodulation, Radiology, Institut Pprime (PPRIME), Université de Poitiers-ENSMA-Centre National de la Recherche Scientifique (CNRS), prismatics (PRISMATICS), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Department of Spine Surgery & Neuromodulation, Poitiers University Hospital, 86021 Poitiers, France, Laboratoire de Mathématiques et Applications (LMA-Poitiers), Université de Poitiers-Centre National de la Recherche Scientifique (CNRS), Department of Neurosurgery, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium, STUMULUS Research Group, Vrije Universiteit Brussel, 1090 Brussels, Belgium, Institut de Mathématiques de Bourgogne [Dijon] (IMB), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université de Bourgogne (UB), Procédés Alimentaires et Microbiologiques [Dijon] (PAM), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Dynamiques européennes (DynamE), Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Pain Evaluation and Treatment Centre, Poitiers University Hospital, 86021 Poitiers, France, Pain Evaluation and Treatment Centre, La Rochelle Hospital, 17000 La Rochelle, France, Pain Evaluation and Treatment Centre, Nord Deux-Sèvres Hospital, 79000 Niort, France, Pain Evaluation and Treatment Centre, Centre Clinical Elsan, 16800 Soyaux, France, Physical and Rehabilitation Medicine Unit, Poitiers University Hospital, University of Poitiers, 86021 Poitiers, France, Service des Technologies de l’Information et de la Communication (STIC), CEA Cadarache, Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), STIMULUS research group, Vrije Universiteit Brussel, 1090 Brussels, Belgium, MedtronicERP NM-3351Poitiers University Hospital, France, Photomécanique et analyse expérimentale en Mécanique des solides (PEM), Département Génie Mécanique et Systèmes Complexes (GMSC), Université de Poitiers-ENSMA-Centre National de la Recherche Scientifique (CNRS)-Université de Poitiers-ENSMA-Centre National de la Recherche Scientifique (CNRS)-Institut Pprime (PPRIME), Université de Poitiers-ENSMA-Centre National de la Recherche Scientifique (CNRS)-Université de Poitiers-ENSMA-Centre National de la Recherche Scientifique (CNRS), Université de Bourgogne (UB)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS), and Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Université Bourgogne Franche-Comté [COMUE] (UBFC)

Subjects
Index (economics), pain mapping, functional capacity, 030204 cardiovascular system & hematology, computer.software_genre, Machine Learning, surgery, 0302 clinical medicine, Quality of life, psychological distress, Pain assessment, [MATH.MATH-ST]Mathematics [math]/Statistics [math.ST], 030212 general & internal medicine, Quality Of Life, media_common, pain intensity, [STAT.AP]Statistics [stat]/Applications [stat.AP], anxiety and depression, 05 social sciences, Chronic pain, General Medicine, Spinal pain, 3. Good health, Medicine, PSPS, composite score, chronic pain, medicine.medical_specialty, Composite score, media_common.quotation_subject, pain surface, Machine learning, Article, 03 medical and health sciences, general_medical_research, Perception, 0502 economics and business, medicine, failed back surgery syndrome (FBSS), In patient, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, business.industry, medicine.disease, Spinal surgery, Anesthesiology and Pain Medicine, Multi dimensional, Physical therapy, 050211 marketing, Observational study, Pairwise comparison, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Artificial intelligence, failed back surgery syndrome, business, computer, 030217 neurology & neurosurgery
Abstract

The multidimensionality of chronic pain forces us to look beyond isolated assessment such as pain intensity, which does not consider multiple key parameters, particularly in post-operative Persistent Spinal Pain Syndrome (PSPS-T2) patients. Our ambition was to produce a novel Multi-dimensional Clinical Response Index (MCRI), including not only pain intensity but also functional capacity, anxiety-depression, quality of life and quantitative pain mapping, the objective being to achieve instantaneous assessment using machine learning techniques. Two hundred PSPS-T2 patients were enrolled in the real-life observational prospective PREDIBACK study with 12-month follow-up and received various treatments. From a multitude of questionnaires/scores, specific items were combined, as exploratory factor analyses helped to create a single composite MCRI, using pairwise correlations between measurements, it appeared to more accurately represent all pain dimensions than any previous classical score. It represented the best compromise among all existing indexes, showing the highest sensitivity/specificity related to Patient Global Impression of Change (PGIC). Novel composite indexes could help to refine pain assessment by informing the physician’s perception of patient condition on the basis of objective and holistic metrics, and also by providing new insights regarding therapy efficacy/patient outcome assessments, before ultimately being adapted to other pathologies.

Published
2021

6. Professional Status of Persistent Spinal Pain Syndrome Patients after Spinal Surgery (PSPS-T2): What Really Matters? A Prospective Study Introducing the Concept of 'Adapted Professional Activity' Inferred from Clinical, Psychological and Social Influence

Author

Pierre Pries, Delphine Rannou, Lisa Goudman, Philippe Page, Amine Ounajim, Géraldine Brumauld de Montgazon, Simon Teyssedou, Laure Poupin, Philippe Cornet, Yassine Abdollah Moufid, Sandrine Baron, Elodie Charrier, Bertille Lorgeoux, Cecile Swennen, Kevin Nivole, Manuel Roulaud, Romain David, Pierre François Descoins, Philippe Rigoard, Brigitte Roy-Moreau, Maxime Billot, Tanguy Vendeuvre, Nicolas Naiditch, Maarten Moens, Nelly Grimaud, Supporting clinical sciences, Neurosurgery, Pain in Motion, Neuroprotection & Neuromodulation, Radiology, prismatics (PRISMATICS), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Université de Strasbourg (UNISTRA), Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Sorbonne Université - Département de médecine générale, Sorbonne Université (SU), Hôpital Saint-Louis de La Rochelle (CH La Rochelle), Centre hospitalier Nord des Deux Sèvres, ELSAN Polyclinique Majorelle, Institut Pprime (PPRIME), and Université de Poitiers-ENSMA-Centre National de la Recherche Scientifique (CNRS)

Subjects
Mediation (statistics), medicine.medical_specialty, unemployment, Hospital Anxiety and Depression Scale, Article, social workers, surgery, 03 medical and health sciences, 0302 clinical medicine, medicine, inference in medicine, 030212 general & internal medicine, Failed Back Surgery Syndrome, Prospective cohort study, social factors, Social influence, Social work, business.industry, social gradient, Chronic pain, General Medicine, medicine.disease, Mental health, professional status, Oswestry Disability Index, Anesthesiology and Pain Medicine, Physical therapy, Medicine, business, chronic pain, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 030217 neurology & neurosurgery
Abstract

Persistent Spinal Pain Syndrome Type 2 (PSPS-T2) represents a main cause of work disruption. Beyond its societal consequences, occupational inactivity is responsible for a major decrease in physical/mental health in individuals but remains poorly analyzed. We designed a study to prospectively examine Professional Status (PS) evolution and its association with key bio-psychological markers. Data from 151 consecutively included working-age PSPS-T2 patients were analyzed to determine the proportion of professional inactivity and the relationships between PS and Social Gradient of Health (SGH), Numeric Pain Rating Scale (NPRS), EuroQol 5-Dimensional 5-Level (EQ-5D-5L), Oswestry Disability Index (ODI), Hospital Anxiety and Depression Scale (HADS), and Fear-Avoidance Belief Questionnaire work subscale (FABQ-W). Despite optimized medical management, 73.5% of PSPS-T2 patients remained inactive after 1 year of follow-up/p = 0.18. Inactive patients presented a low SGH/p = 0.002, higher NPRS/p = 0.048, lower EQ-5D-5L/p &lt, 0.001, higher ODI/p = 0.018, higher HADS-D/p = 0.019 and higher FABQ-W/p &lt, 0.001. No significant mediation effect of FABQ-W on SGH consequences regarding PS was observed in our structural model/p = 0.057. The link between unemployment and bio-psycho-social pain dimensions appears bidirectional and justifies intense collaboration with social workers. Optimizing therapeutical sequencing towards personalized professional plans implies restoring “Adapted Physical Function” as an initial goal, and tailoring an “Adapted Professional Activity”, matching with patient expectations and capabilities, as a final objective.

Published
2021

7. PO173 / #1050 PROFESSIONAL STATUS OF PERSISTENT SPINAL PAIN SYNDROME PATIENTS AFTER SPINAL SURGERY (PSPS-T2): A PROSPECTIVE STUDY INTRODUCING THE CONCEPT OF 'ADAPTED PROFESSIONAL ACTIVITY' INFERRED BIOPSYCHOSOCIAL INFLUENCE

Author

Nicolas Naiditch, Maxime Billot, Lisa Goudman, Philippe Cornet, Manuel Roulaud, Amine Ounajim, Philippe Page, Bertille Lorgeoux, Sandrine Baron, Kevin Nivole, Pierre Pries, Yassine Abdollah Moufid, Cécile Swennen, Simon Teyssedo, Elodie Charrier, Laure Poupin, Delphine Rannou, Géraldine Brumauld De Montgazon, Pierre François Descoins, Aline Roy-Moreau, Nelly Grimaud, Romain David, Maarten Moens, and Philippe Rigoard

Subjects
Anesthesiology and Pain Medicine, Neurology, Neurology (clinical), General Medicine
Published
2022

8. O089 / #1051 PERSISTENT SPINAL PAIN SYNDROME MANAGEMENT: HOW TO CHANGE THE PARADIGM?

Author

Philippe Rigoard, Amine Ounajim, Lisa Goudman, Pierre-Yves Louis, Yousri Slaoui, Manuel Roulaud, Nicolas Naiditch, Bénédicte Bouche, Philippe Page, Bertille Lorgeoux, Sandrine Baron, Elodie Charrier, Laure Poupin, Delphine Rannou, Géraldine Brumauld De Montgazon, Aline Roy-Moreau, Nelly Grimaud, Nihel Adjali, Kevin Nivole, Mathilde Many, Romain David, Chantal Wood, Raphael Rigoard, Maarten Moens, and Maxime Billot

Subjects
Anesthesiology and Pain Medicine, Neurology, Neurology (clinical), General Medicine
Published
2022

9. Persistent Spinal Pain Syndrome Type 2 (PSPS-T2), a Social Pain? Advocacy for a Social Gradient of Health Approach to Chronic Pain

Author

Romain David, David Le Breton, Tanguy Vendeuvre, Géraldine Brumauld de Montgazon, Maxime Billot, Manuel Roulaud, Kevin Nivole, Pierre François Descoins, Nicolas Naiditch, Brigitte Roy-Moreau, Cecile Swennen, Nelly Grimaud, Philippe Rigoard, Philippe Page, Maarten Moens, Elodie Charrier, Bertille Lorgeoux, Philippe Cornet, Lisa Goudman, Simon Teyssedou, Pierre Pries, Amine Ounajim, Dynamiques européennes (DynamE), Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Universitair Ziekenhus Brussel (UZ Brussel), Sorbonne Université - Département de médecine générale, Sorbonne Université (SU), Centre hospitalier Nord des Deux Sèvres, ELSAN Polyclinique Majorelle, Pain in Motion, Supporting clinical sciences, Neuroprotection & Neuromodulation, Radiology, and Neurosurgery

Subjects
medicine.medical_specialty, Kinesiophobia, Neuroscience(all), Social gradient, Article, social gradient of health, surgery, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Internal medicine, medicine, [SDV.MHEP.AHA]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], 030212 general & internal medicine, Social determinants of health, Syndrome type, business.industry, Chronic pain, General Medicine, medicine.disease, Spinal pain, 3. Good health, persistent spinal pain syndrome type 2, social determinants of health, Social hierarchy, Medicine, failed back surgery syndrome, business, 030217 neurology & neurosurgery
Abstract

The Social Gradient of Health (SGH), or position in the social hierarchy, is one of the major determinants of health. It influences the development and evolution of many chronic diseases. Chronic pain dramatically affects individual and social condition. Its medico-economic impact is significant and worldwide. Failed Back Surgery Syndrome or Persistent Spinal Pain Syndrome type 2 (PSPS-T2) represents one of its most fascinating and disabling conditions. However, the influence of SGH on PSPS-T2 has been poorly explored. We designed a prospective multicentric study (PREDIBACK study) to assess the SGH prevalence, and to examine its association with medical and psychological variables, in PSPS-T2 patients. This study included 200 patients to determine the SGH association with pain (NPRS), Quality of life (EQ-5D-5L), kinesiophobia (FABQ-Work), catastrophism (CSQ), and functional capacity (ODI). Around 85.3% of PSPS-T2 patients in our study had low SGH. Low SGH patients had a higher FABQ-Work and CSQ-Catastrophizing score than high SGH patients (p &lt, 0.05). High SGH patients have a higher ODI score than low SGH patients (p &lt, 0.10). Our results suggest that SGH is a relevant factor to guide prevention, research, and ultimately intervention in PSPS-T2 patients and could be more widely transposed to chronic pain.

Published
2021

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