Impact of Ambulatory Setting for Workers’ Compensation Patients Undergoing One-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion and Review of the Literature

To compare perioperative characteristics and patient-reported outcome measures (PROMs) in workers’ compensation (WC) patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in either the inpatient/outpatient setting. Patients with WC undergoing 1-level MIS-TLIF were...

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Vydáno v:World neurosurgery Ročník 167; s. e251 - e267
Hlavní autoři: Nie, James W., Hartman, Timothy J., Pawlowski, Hanna, Prabhu, Michael C., Vanjani, Nisheka N., Oyetayo, Omolabake O., Singh, Kern
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Elsevier Inc 01.11.2022
Témata:
Disability Evaluation
Humans
Inpatient
Lumbar Vertebrae - surgery
MCID
Minimally Invasive Surgical Procedures - methods
MIS-TLIF
Outpatient
PROM
Spinal Fusion - methods
Treatment Outcome
Workers' Compensation
Workers’ Compensation
PROM
PROMIS-PF
VAS
WC
MIS-TLIF
EBL
ASA
LOS
SF-12 PCS
MCID
ODI
Inpatient
Outpatient
BMI
ISSN:1878-8750, 1878-8769, 1878-8769
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Popis
Shrnutí:To compare perioperative characteristics and patient-reported outcome measures (PROMs) in workers’ compensation (WC) patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in either the inpatient/outpatient setting. Patients with WC undergoing 1-level MIS-TLIF were included. Patients were separated into inpatient/outpatient groups and demographically propensity score matched. PROMs included visual analog scale (VAS) back/VAS leg/Oswestry Disability Index (ODI)/12-item Short Form Physical Composite Score (SF-12 PCS)/Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF) preoperatively and 6 weeks, 12 weeks, 6 months, and 1 year postoperatively. Results were compared preoperatively and postoperatively and between cohorts. Minimum clinically important difference (MCID) achievement was determined through comparison with values established in the literature. A total of 216 patients were included (184 inpatient). The inpatient cohort (IC) showed worse perioperative outcomes in multiple measures (P < 0.034; all). The IC improved in all PROMs (P < 0.038; all), besides ODI at 6 weeks, SF-12 PCS at 6 weeks/6 months/1 year, and PROMIS-PF at 6 weeks. The outpatient cohort (OC) improved in VAS back at all time points and VAS leg at 6 months (P < 0.033; all). Between cohorts, the OC showed better scores with VAS leg/ODI/SF-12 PCS/PROMIS-PF at multiple time points (P < 0.031; all). Most of the IC achieved MCID, aside from ODI, whereas the OC achieved MCID in SF-12 PCS. MCID achievement between cohorts was higher in the IC at PROMIS-PF at 1 year and VAS back overall (P < 0.034; all). Despite more comorbidities and worse perioperative measures, the IC showed improved PROMs from preoperative to ≥1 follow-up visit, whereas the OC had improvement with only VAS back and leg. The IC showed multiple MCID achievements, whereas the OC showed MCID in only SF-12 PCS. These findings may help guide a surgeon’s decision making between inpatient/outpatient lumbar surgery in the WC population.
Bibliografie:ObjectType-Article-2
SourceType-Scholarly Journals-1
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ISSN:1878-8750
1878-8769
1878-8769
DOI:10.1016/j.wneu.2022.07.136