Change in Patient-Reported Outcome Measures as Predictors of Revision Lumbar Decompression Procedures

Michael T. Nolte; Elliot D.K. Cha; Conor P. Lynch; Kevin C. Jacob; Madhav R. Patel; Cara E. Geoghegan; Caroline N. Jadczak; Shruthi Mohan; Kern Singh

doi:10.14245/ns.2142230.115

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자료유형: 학술저널

저자정보: Michael T. Nolte (Department of Orthopaedic Surgery Rush University Medical Center) Elliot D.K. Cha (Department of Orthopaedic Surgery Rush University Medical Center) Conor P. Lynch (Department of Orthopaedic Surgery Rush University Medical Center) Kevin C. Jacob (Department of Orthopaedic Surgery Rush University Medical Center) Madhav R. Patel (Department of Orthopaedic Surgery Rush University Medical Center) Cara E. Geoghegan (Department of Orthopaedic Surgery Rush University Medical Center) Caroline N. Jadczak (Department of Orthopaedic Surgery Rush University Medical Center) Shruthi Mohan (Department of Orthopaedic Surgery Rush University Medical Center) Kern Singh (Department of Orthopaedic Surgery Rush University Medical Center)

저널정보: 대한척추신경외과학회 Neurospine Neurospine 제18권 제4호

발행연도: 2021.12

수록면: 863 - 870 (8page)

DOI: 10.14245/ns.2142230.115

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Objective: To assess change in Patient-Reported Outcome Measures (PROM) as predictors for revision lumbar decompression (LD). Methods: Patients who underwent primary, single or multilevel LD were retrospectively reviewed. Patients were categorized according to whether or not they underwent revision LD within 2 years of the primary procedure. Visual analogue scale (VAS), Oswestry Disability Index (ODI), 12-item Short Form Health Survey and 12-item Veterans RAND physical component score (SF-12 PCS and VR-12 PCS), and Patient-Reported Outcome Measurement Information System physical function (PROMIS-PF) were recorded. Delta PROM scores were evaluated for differences between groups and as a risk factor for a revision LD. Results: The study included 135 patients, 91 undergoing a primary procedure only and 44 undergoing a primary and revision procedure. Matched patients did not demonstrate any significant differences in demographics or perioperative characteristics. Patients who underwent a revision had a mean time to revision of 7.4±5.7 months. Primary cohort significantly improved for all PROMs (all p<0.05), while the primary plus revision cohort significantly improved for VAS back, ODI, and PROMIS-PF (all p<0.05). However, cohorts differed in VAS back and PROMIS-PF (p<0.05). Delta PROMs were not a significant risk factor for revision except at 6 months for PROMIS-PF (p=0.024). Conclusion: LD has been associated with reliable outcomes, but early identification of patients at risk for revision is critical. This study suggests that tools such as PROMIS-PF may serve a role in predicting who is at risk and the 6-month follow-up period may be valuable for counseling patients who are not experiencing improvement.

#Lumbar vertebrae #Decompression #Patient-Reported Outcome Measures

참고문헌 (25)

참고문헌 신청

Jain S / 2020 / Minimally invasive lumbar decompression : a review of indications, techniques, efficacy and safety / Pain Manag 10:331~348

Lingreen R / 2010 / Retrospective review of patient selfreported improvement and post-procedure findings for mild(minimally invasive lumbar decompression) / Pain Physician 13:555~560

Proietti L / 2013 / Complications in lumbar spine surgery : A retrospective analysis / Indian J Orthop 47:340~345

Singh K / 2015 / Minimally invasive versus open single-level transforaminal lumbar interbody fusion : surgical outcomes, functional capacity and narcotic utilization / Spine J 15:S261

Hee-Jong Hwang / 2016 / Predictors of Reoperation after Microdecompression in Lumbar Spinal Stenosis / Neurospine 13(4):183~189

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