PMID- 23157276
OWN - NLM
STAT- MEDLINE
DCOM- 20130304
LR  - 20220321
IS  - 1547-5646 (Electronic)
IS  - 1547-5646 (Linking)
VI  - 18
IP  - 1
DP  - 2013 Jan
TI  - Differentiating minimum clinically important difference for primary and revision 
      lumbar fusion surgeries.
PG  - 102-6
LID - 10.3171/2012.10.SPINE12727 [doi]
AB  - OBJECT: Previous studies have reported on the minimum clinically important 
      difference (MCID), a threshold of improvement that is clinically relevant for 
      lumbar degenerative disorders. Recent studies have shown that pre- and 
      postoperative health-related quality of life (HRQOL) measures vary among patients 
      with different diagnostic etiologies. There is also concern that a patient's 
      previous care experience may affect his or her perception of clinical 
      improvement. This study determined if MCID values for the Oswestry Disability 
      Index (ODI), 36-Item Short-Form Health Survey (SF-36), and back and leg pain are 
      different between patients undergoing primary or revision lumbar fusion. METHODS: 
      Prospectively collected preoperative and 1-year postoperative patient-reported 
      HRQOLs, including the ODI, SF-36 physical component summary (PCS), and numeric 
      rating scales (0-10) for back and leg pain, in patients undergoing lumbar spine 
      fusion were analyzed. Patients were grouped into either the primary surgery or 
      revision group. As the most widely accepted MCID values were calculated from the 
      minimum detectable change, this method was used to determine the MCID. RESULTS: A 
      total of 722 patients underwent primary procedures and 333 patients underwent 
      revisions. There was no statistically significant difference in demographics 
      between the groups. Each group had a statistically significant improvement at 1 
      year postoperatively compared with baseline. The minimum detectable 
      change-derived MCID values for the primary group were 1.16 for back pain, 1.36 
      for leg pain, 12.40 for ODI, and 5.21 for SF-36 PCS. The MCID values for the 
      revision group were 1.21 for back pain, 1.28 for leg pain, 11.79 for ODI, and 
      4.90 for SF-36 PCS. These values are very similar to those previously reported in 
      the literature. CONCLUSIONS: The MCID values were similar for the revision and 
      primary lumbar fusion groups, even when subgroup analysis was done for different 
      diagnostic etiologies, simplifying interpretation of clinical improvement. The 
      results of this study further validate the use of patient-reported HRQOLs to 
      measure clinical effectiveness, as a patient's previous experience with care does 
      not seem to substantially alter an individual's perception of clinical 
      improvement.
FAU - Carreon, Leah Y
AU  - Carreon LY
AD  - Norton Leatherman Spine Center, Louisville, KY 40202, USA. 
      leah.carreon@nortonhealthcare.org
FAU - Bratcher, Kelly R
AU  - Bratcher KR
FAU - Canan, Chelsea E
AU  - Canan CE
FAU - Burke, Lauren O
AU  - Burke LO
FAU - Djurasovic, Mladen
AU  - Djurasovic M
FAU - Glassman, Steven D
AU  - Glassman SD
LA  - eng
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20121116
PL  - United States
TA  - J Neurosurg Spine
JT  - Journal of neurosurgery. Spine
JID - 101223545
SB  - IM
MH  - Adult
MH  - Aged
MH  - Back Pain/diagnosis/*surgery
MH  - Disability Evaluation
MH  - Health Status
MH  - Health Surveys
MH  - Humans
MH  - Lumbar Vertebrae/*surgery
MH  - Middle Aged
MH  - Pain Measurement
MH  - Prospective Studies
MH  - *Quality of Life
MH  - Reoperation
MH  - *Spinal Fusion
MH  - Treatment Outcome
EDAT- 2012/11/20 06:00
MHDA- 2013/03/05 06:00
CRDT- 2012/11/20 06:00
PHST- 2012/11/20 06:00 [entrez]
PHST- 2012/11/20 06:00 [pubmed]
PHST- 2013/03/05 06:00 [medline]
AID - 10.3171/2012.10.SPINE12727 [doi]
PST - ppublish
SO  - J Neurosurg Spine. 2013 Jan;18(1):102-6. doi: 10.3171/2012.10.SPINE12727. Epub 
      2012 Nov 16.