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논문 기본 정보

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저자정보
Ishan Khosla (Department of Orthopaedic Surgery, Rush University Medical Center) Fatima N. Anwar (Department of Orthopaedic Surgery, Rush University Medical Center) Andrea M. Roca (Department of Orthopaedic Surgery, Rush University Medical Center) Srinath S. Medakkar (Department of Orthopaedic Surgery, Rush University Medical Center) Alexandra C. Loya (Department of Orthopaedic Surgery, Rush University Medical Center) Aayush Kaul (Chicago Medical School at Rosalind Franklin University of Medicine and Science) Jacob C. Wolf (Chicago Medical School at Rosalind Franklin University of Medicine and Science) Vincent P. Federico (Department of Orthopaedic Surgery, Rush University Medical Center) Arash J. Sayari (Department of Orthopaedic Surgery, Rush University Medical Center) Gregory D. Lopez (Department of Orthopaedic Surgery, Rush University Medical Center) Kern Singh (Department of Orthopaedic Surgery, Rush University Medical Center)
저널정보
대한척추신경외과학회 Neurospine Neurospine Vol.21 No.1
발행연도
2024.3
수록면
253 - 260 (8page)
DOI
10.14245/ns.2347080.540

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초록· 키워드

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Objective: To evaluate preoperative disability’s influence on patient-reported outcomes (PROs) following surgery for degenerative spondylolisthesis (DS). Methods: DS patients who underwent surgical intervention were retrospectively identified from a single-surgeon spine registry. Cohorts based on Oswestry Disability Index (ODI) < 41 (milder disability) and ≥ 41 (severe disability) were created. Demographic differences were accounted for with 1:1 propensity score matching. For the matched sample, perioperative and PRO data were additionally collected. PROs assessed included mental health, physical function, pain, and disability. Pre- and up to 2-year postoperative PROs were utilized. Average time to final follow-up was 15.7 ± 8.8 months. Improvements in PROs and minimal clinically important difference (MCID) rates were calculated. Continuous variables were compared through Student t-test and categorical variables were compared through chi-square tests. Results: Altogether, 214 patients were included with 77 in the milder disability group. The severe disability group had worse postoperative day (POD) 1 pain scores and longer hospital stays (p ≤ 0.038, both). The severe disability group reported worse outcomes pre- and postoperatively (p < 0.011, all), but had greater average improvement in 12-item Short Form health survey mental composite score (SF-12 MCS), 9-Item Patient Health Questionnaire (PHQ-9), visual analogue scale (VAS)-back, and ODI by 6 weeks (p ≤ 0.037, all) and PHQ-9, VAS-back and ODI by final follow-up (p ≤ 0.015, all). The severe disability cohort was more likely to achieve MCID for SF-12 MCS, PHQ-9, and ODI (p ≤ 0.003, all). Conclusion: Patients with greater baseline disability report higher POD 1 pain and discharge later than patients with milder disability. While these patients report inferior physical/mental health before and after surgery, they report greater improvements in mental health and disability postoperatively.
#Degenerative spondylolisthesis #Disability #Mental health #Patient-reported outcomes

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