Comparing Patient-Reported Outcomes in Patients Undergoing Lumbar Fusion for Isthmic Spondylolisthesis with Predominant Back Pain versus Predominant Leg Pain Symptoms

To compare patient-reported outcome measures (PROMs) and minimum clinically important difference (MCID) achievement following anterior or transforaminal lumbar interbody fusion for isthmic spondylolisthesis in patients presenting with predominant back pain versus predominant leg pain symptoms. A sin...

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Vydáno v:	World neurosurgery Ročník 166; s. e672 - e680
Hlavní autoři:	Jacob, Kevin C., Patel, Madhav R., Vanjani, Nisheka N., Pawlowski, Hanna, Prabhu, Michael C., Singh, Kern
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States Elsevier Inc 01.10.2022
Témata:	ALIF Back pain Back Pain - etiology Back Pain - surgery Humans Isthmic spondylolisthesis Leg pain outcomes Lumbar Vertebrae - surgery Minimally Invasive Surgical Procedures Narcotics Patient Reported Outcome Measures Retrospective Studies Spinal Fusion - methods Spondylolisthesis - complications Spondylolisthesis - surgery TLIF Treatment Outcome Back pain SPORT Isthmic spondylolisthesis Leg pain outcomes PROM PROMIS-PF VAS SF-12 MCS TLIF SF-12 PCS MCID ODI ALIF MIS
ISSN:	1878-8750, 1878-8769, 1878-8769
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Abstract	To compare patient-reported outcome measures (PROMs) and minimum clinically important difference (MCID) achievement following anterior or transforaminal lumbar interbody fusion for isthmic spondylolisthesis in patients presenting with predominant back pain versus predominant leg pain symptoms. A single-surgeon database was reviewed for anterior or transforaminal lumbar interbody fusion procedures for isthmic spondylolisthesis. Patient demographics, perioperative characteristics, postoperative complications, and PROMs were collected. Demographic/perioperative characteristics were compared among groups using χ2 and Student t tests for categorical and continuous variables, respectively. Mean PROM scores were compared using an unpaired Student t test. Postoperative improvement from preoperative baseline within each cohort was assessed with paired-samples t test. MCID achievement rates were compared with χ2 analysis. In total, 143 patients were included with 65 patients in the predominant back pain and 78 patients in the predominant leg pain cohort. Preoperative visual analog scale (VAS) leg was noted to be significantly greater in predominant leg pain cohort (P < 0.001). Cohorts demonstrated significant mean postoperative differences for the following PROMs at the following postoperative time points: significant differences were noted between cohorts for rate of achievement of MCID for the following PROMs at the following time points: VAS back at 2 years and VAS leg at 6 weeks/12 weeks/6 months/overall (P < 0.036, all). Compared with patients presenting for surgery with predominant leg pain symptoms, patients undergoing lumbar fusion at L4–L5 and L5–S1 for isthmic spondylolisthesis with predominant back pain symptoms may demonstrate improved long-term clinical outcomes for reported back pain, leg pain, and disability and reduced postoperative length of stay and narcotic consumption.
AbstractList	To compare patient-reported outcome measures (PROMs) and minimum clinically important difference (MCID) achievement following anterior or transforaminal lumbar interbody fusion for isthmic spondylolisthesis in patients presenting with predominant back pain versus predominant leg pain symptoms. A single-surgeon database was reviewed for anterior or transforaminal lumbar interbody fusion procedures for isthmic spondylolisthesis. Patient demographics, perioperative characteristics, postoperative complications, and PROMs were collected. Demographic/perioperative characteristics were compared among groups using χ2 and Student t tests for categorical and continuous variables, respectively. Mean PROM scores were compared using an unpaired Student t test. Postoperative improvement from preoperative baseline within each cohort was assessed with paired-samples t test. MCID achievement rates were compared with χ2 analysis. In total, 143 patients were included with 65 patients in the predominant back pain and 78 patients in the predominant leg pain cohort. Preoperative visual analog scale (VAS) leg was noted to be significantly greater in predominant leg pain cohort (P < 0.001). Cohorts demonstrated significant mean postoperative differences for the following PROMs at the following postoperative time points: significant differences were noted between cohorts for rate of achievement of MCID for the following PROMs at the following time points: VAS back at 2 years and VAS leg at 6 weeks/12 weeks/6 months/overall (P < 0.036, all). Compared with patients presenting for surgery with predominant leg pain symptoms, patients undergoing lumbar fusion at L4–L5 and L5–S1 for isthmic spondylolisthesis with predominant back pain symptoms may demonstrate improved long-term clinical outcomes for reported back pain, leg pain, and disability and reduced postoperative length of stay and narcotic consumption. To compare patient-reported outcome measures (PROMs) and minimum clinically important difference (MCID) achievement following anterior or transforaminal lumbar interbody fusion for isthmic spondylolisthesis in patients presenting with predominant back pain versus predominant leg pain symptoms. A single-surgeon database was reviewed for anterior or transforaminal lumbar interbody fusion procedures for isthmic spondylolisthesis. Patient demographics, perioperative characteristics, postoperative complications, and PROMs were collected. Demographic/perioperative characteristics were compared among groups using χ and Student t tests for categorical and continuous variables, respectively. Mean PROM scores were compared using an unpaired Student t test. Postoperative improvement from preoperative baseline within each cohort was assessed with paired-samples t test. MCID achievement rates were compared with χ analysis. In total, 143 patients were included with 65 patients in the predominant back pain and 78 patients in the predominant leg pain cohort. Preoperative visual analog scale (VAS) leg was noted to be significantly greater in predominant leg pain cohort (P < 0.001). Cohorts demonstrated significant mean postoperative differences for the following PROMs at the following postoperative time points: significant differences were noted between cohorts for rate of achievement of MCID for the following PROMs at the following time points: VAS back at 2 years and VAS leg at 6 weeks/12 weeks/6 months/overall (P < 0.036, all). Compared with patients presenting for surgery with predominant leg pain symptoms, patients undergoing lumbar fusion at L4-L5 and L5-S1 for isthmic spondylolisthesis with predominant back pain symptoms may demonstrate improved long-term clinical outcomes for reported back pain, leg pain, and disability and reduced postoperative length of stay and narcotic consumption. To compare patient-reported outcome measures (PROMs) and minimum clinically important difference (MCID) achievement following anterior or transforaminal lumbar interbody fusion for isthmic spondylolisthesis in patients presenting with predominant back pain versus predominant leg pain symptoms.OBJECTIVETo compare patient-reported outcome measures (PROMs) and minimum clinically important difference (MCID) achievement following anterior or transforaminal lumbar interbody fusion for isthmic spondylolisthesis in patients presenting with predominant back pain versus predominant leg pain symptoms.A single-surgeon database was reviewed for anterior or transforaminal lumbar interbody fusion procedures for isthmic spondylolisthesis. Patient demographics, perioperative characteristics, postoperative complications, and PROMs were collected. Demographic/perioperative characteristics were compared among groups using χ2 and Student t tests for categorical and continuous variables, respectively. Mean PROM scores were compared using an unpaired Student t test. Postoperative improvement from preoperative baseline within each cohort was assessed with paired-samples t test. MCID achievement rates were compared with χ2 analysis.METHODSA single-surgeon database was reviewed for anterior or transforaminal lumbar interbody fusion procedures for isthmic spondylolisthesis. Patient demographics, perioperative characteristics, postoperative complications, and PROMs were collected. Demographic/perioperative characteristics were compared among groups using χ2 and Student t tests for categorical and continuous variables, respectively. Mean PROM scores were compared using an unpaired Student t test. Postoperative improvement from preoperative baseline within each cohort was assessed with paired-samples t test. MCID achievement rates were compared with χ2 analysis.In total, 143 patients were included with 65 patients in the predominant back pain and 78 patients in the predominant leg pain cohort. Preoperative visual analog scale (VAS) leg was noted to be significantly greater in predominant leg pain cohort (P < 0.001). Cohorts demonstrated significant mean postoperative differences for the following PROMs at the following postoperative time points: significant differences were noted between cohorts for rate of achievement of MCID for the following PROMs at the following time points: VAS back at 2 years and VAS leg at 6 weeks/12 weeks/6 months/overall (P < 0.036, all).RESULTSIn total, 143 patients were included with 65 patients in the predominant back pain and 78 patients in the predominant leg pain cohort. Preoperative visual analog scale (VAS) leg was noted to be significantly greater in predominant leg pain cohort (P < 0.001). Cohorts demonstrated significant mean postoperative differences for the following PROMs at the following postoperative time points: significant differences were noted between cohorts for rate of achievement of MCID for the following PROMs at the following time points: VAS back at 2 years and VAS leg at 6 weeks/12 weeks/6 months/overall (P < 0.036, all).Compared with patients presenting for surgery with predominant leg pain symptoms, patients undergoing lumbar fusion at L4-L5 and L5-S1 for isthmic spondylolisthesis with predominant back pain symptoms may demonstrate improved long-term clinical outcomes for reported back pain, leg pain, and disability and reduced postoperative length of stay and narcotic consumption.CONCLUSIONSCompared with patients presenting for surgery with predominant leg pain symptoms, patients undergoing lumbar fusion at L4-L5 and L5-S1 for isthmic spondylolisthesis with predominant back pain symptoms may demonstrate improved long-term clinical outcomes for reported back pain, leg pain, and disability and reduced postoperative length of stay and narcotic consumption.
Author	Vanjani, Nisheka N. Jacob, Kevin C. Patel, Madhav R. Pawlowski, Hanna Singh, Kern Prabhu, Michael C.
Author_xml	– sequence: 1 givenname: Kevin C. surname: Jacob fullname: Jacob, Kevin C. – sequence: 2 givenname: Madhav R. surname: Patel fullname: Patel, Madhav R. – sequence: 3 givenname: Nisheka N. surname: Vanjani fullname: Vanjani, Nisheka N. – sequence: 4 givenname: Hanna orcidid: 0000-0002-9475-2574 surname: Pawlowski fullname: Pawlowski, Hanna – sequence: 5 givenname: Michael C. surname: Prabhu fullname: Prabhu, Michael C. – sequence: 6 givenname: Kern orcidid: 0000-0002-6118-7273 surname: Singh fullname: Singh, Kern email: kern.singh@rushortho.com
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Cites_doi	10.1016/j.bpa.2016.01.002 10.1097/BRS.0b013e31819fcf35 10.3171/2019.1.SPINE18770 10.1016/j.jcm.2011.11.001 10.1097/BRS.0000000000001211 10.1177/2192568219856871 10.1097/BSD.0000000000000358 10.5435/00124635-200910000-00003 10.3928/0147-7447-20011201-09 10.1097/BRS.0b013e3181d77c21 10.1097/BRS.0000000000000101 10.1097/01.brs.0000181057.60012.08 10.1097/00007632-200007010-00016 10.1016/j.nec.2019.02.001 10.1097/BRS.0b013e3181a105fc 10.1097/BRS.0000000000004333 10.1016/j.spinee.2020.05.164 10.1016/j.wneu.2016.06.120 10.1016/j.spinee.2008.11.009
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Keywords	Back pain SPORT Isthmic spondylolisthesis Leg pain outcomes PROM PROMIS-PF VAS SF-12 MCS TLIF SF-12 PCS MCID ODI ALIF MIS
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Snippet	To compare patient-reported outcome measures (PROMs) and minimum clinically important difference (MCID) achievement following anterior or transforaminal lumbar...
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SubjectTerms	ALIF Back pain Back Pain - etiology Back Pain - surgery Humans Isthmic spondylolisthesis Leg pain outcomes Lumbar Vertebrae - surgery Minimally Invasive Surgical Procedures Narcotics Patient Reported Outcome Measures Retrospective Studies Spinal Fusion - methods Spondylolisthesis - complications Spondylolisthesis - surgery TLIF Treatment Outcome
Title	Comparing Patient-Reported Outcomes in Patients Undergoing Lumbar Fusion for Isthmic Spondylolisthesis with Predominant Back Pain versus Predominant Leg Pain Symptoms
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