Prognostic models of non–surgical treatment outcomes for lumbar–related leg pain : a scoping review of systematic reviews

Abstract

Prognosis identifies a relationship between future outcomes and a given health state. Prognostic factors help estimate the likelihood of a particular outcome, regardless of any specific intervention. The prognosis of persons treated for lumbar–related leg pain (LRLP) varies considerably. To the authors’ knowledge, no systematic review (SR) has evaluated any formal combination of multiple predictors (prognostic models) for non–surgical interventions in this population. This scoping review aimed to: (a) determine if SRs specifically evaluating prognostic models of non–surgical interventions for LRLP exist, and (b) identify prognostic models addressing non–surgical interventions in LRLP within the SRs. A systematic search of PubMed, Embase, CINAHL, and Epistemonikos was conducted in October 2024, including SRs published from the year 2000 onwards. References were hand–searched, and forward citation searches were performed. The search identified 9,398 records after deduplication. Following screening, the full texts of 18 SRs were evaluated against the eligibility criteria. The lack of SRs in this area highlights a critical gap in understanding the prognostic models for non– surgical interventions in LRLP. Three reviews reported two primary studies that had derived and/or evaluated prognostic models in cohorts that met the threshold set for this scoping review, with 80% of participants experiencing LRLP. This scoping review highlights a gap in the SR literature evaluating specific prognostic models for non–surgical interventions in individuals with LRLP even though various prognostic models for LRLP exist. This underlines the need for a dedicated SR to consolidate evidence and guide clinical practice in the non–surgical management of LRLP.