Continuity of care in lumbar disc herniation: a systematic review and meta-analysis providing a deeper look into postoperative efficacy
Bibliographic record
Abstract
Background Lumbar disk herniation is a prevalent spinal disorder. Continuity of care ensures seamless, coordinated, and high-quality management across healthcare transitions to optimize outcomes and reduce readmission risk. Insufficient structured postoperative care programs after diskharge may hinder recovery, lower quality of life, and increase complication risks. Objectives This study aims to explore the significance of continuity of care in enhancing the recovery outcomes of patients with lumbar disk herniation post-surgery through a meta-analysis. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted an extensive search across several databases, including MEDLINE (PubMed), EMBASE, Web of Science, Google Scholar, CINAHL, EBSCO, Cochrane Library and Scopus, without restrictions on language or publication date. A meta-analysis was performed using both fixed-effects and random-effects models based on heterogeneity assessment. We analyzed the data using R software version 4.2.2 and Stata software version 15.1. The risk of bias was assessed using the Cochrane Risk of Bias Tool, the Newcastle-Ottawa Scale (NOS), funnel plots, sensitivity analysis, Egger’s test, and Begg’s test. Results This study included a total of 15 studies, involving 1,804 participants. The meta-analysis results showed that the experimental group had significantly lower Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Self-Rating Anxiety Scale (SAS) scores 3 months post-operation compared to the conventional control group [SMD = −0.66, 95% CI (−0.91, −0.41), SMD = −0.91, 95%CI (−1.24, −0.58), SMD = −0.61, 95% CI (−0.91, −0.31), p < 0.01]. Additionally, the Japanese Orthopedic Association (JOA) score of the experimental group was significantly higher than that of the conventional control group at 3 months post-operation [SMD = 1.70, 95%CI (1.01, 2.39), p < 0.01]. Conclusion Our meta-analysis indicates that continued care interventions significantly alleviate postoperative pain, enhance lumbar function, reduce anxiety, and improve overall functional recovery in LDH patients. High-quality continued care interventions are critical strategies for enhancing postoperative recovery outcomes. Nonetheless, as the included primary studies predominantly originate from China, further validation of these findings in diverse regions and populations is warranted in future research. Systematic review registration PROSPERO https://www.crd.york.ac.uk/prospero/ , identifier CRD42024604420.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.043 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.019 | 0.043 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".