PMID- 27111764 OWN - NLM STAT- MEDLINE DCOM- 20170905 LR - 20220408 IS - 1528-1159 (Electronic) IS - 0362-2436 (Linking) VI - 41 IP - 24 DP - 2016 Dec 15 TI - Surgical Resection of Intradural Extramedullary Spinal Tumors: Patient Reported Outcomes and Minimum Clinically Important Difference. PG - 1925-1932 LID - 10.1097/BRS.0000000000001653 [doi] AB - STUDY DESIGN: Analysis of prospectively collected longitudinal web-based registry data. OBJECTIVE: To determine relative validity, responsiveness, and minimum clinically important difference (MCID) thresholds in patients undergoing surgery for intradural extramedullary (IDEM) spinal tumors. SUMMARY OF BACKGROUND DATA: Patient-reported outcomes (PROs) are vital in establishing the value of care in spinal pathology. There is limited availability of prospective, quality studies reporting PROs for IDEM spine tumors. METHODS: . A total of 40 patients were analyzed. Baseline, postoperative 3-month, and 12-month PROs were recorded: Oswestry Disability Index or Neck disability Index (ODI/NDI), Quality of life EuroQol-5D (EQ-5D), Short Form-12 (SF-12), Numeric Rating Scale (NRS)-pain scores. Responders were defined as those who achieved a level of improvement one or two, after surgery, on health transition index (HTI) of SF-36. Receiver-operating characteristic curves were generated to assess the validity of PROs, and the difference between standardized response means (SRMs) in responders versus nonresponders was utilized to determine the relative responsiveness of each PRO measure. MCID thresholds were derived using previously reported minimal detectable change approach. RESULTS: A significant improvement across all PROs at 3-months and 12-months follow up was noted. The derived MCID thresholds were 13.9 points: ODI/NDI, 0.14 quality adjusted life years: EQ-5D, 2.8 points: SF-12PCS and 10.7 points: SF-12MCS, 1.9 points: NRS-back/neck pain, and 1.8 points: NRS-leg/arm pain. SF-12PCS was most accurate discriminator of meaningful improvement (area under the curve, AUC-0.83) and most responsive (SRM-1.36) to postoperative improvement. EQ-5D, ODI/NDI, NRS-pain scores were all accurate discriminator (AUC-0.7-0.8) and responsive measures (0.97-0.67) of meaningful postoperative improvement. SF-12MCS was neither a valid discriminator (AUC-0.48) nor a responsive measure (SRM: -1.5) of outcome. CONCLUSION: Surgical resection of IDEM spinal tumors provides significant and sustained improvement in quality of life, general health, disability, and pain at 12-month after surgery. The surgically resected IDEM-specific clinically meaningful thresholds are reported. All the PROs reported in this study can accurately discriminate responders and nonresponder based on SF-36 HTI index except for SF-12 MCS. LEVEL OF EVIDENCE: 3. FAU - Zuckerman, Scott L AU - Zuckerman SL AD - Department of Orthopedics Surgery and Department of Neurological Surgery, Spinal Column Surgical Quality and Outcomes Research Laboratory, Vanderbilt University Medical Center, Nashville, TN. FAU - Chotai, Silky AU - Chotai S AD - Department of Orthopedics Surgery and Department of Neurological Surgery, Spinal Column Surgical Quality and Outcomes Research Laboratory, Vanderbilt University Medical Center, Nashville, TN. FAU - Devin, Clinton J AU - Devin CJ AD - Department of Orthopedics Surgery and Department of Neurological Surgery, Spinal Column Surgical Quality and Outcomes Research Laboratory, Vanderbilt University Medical Center, Nashville, TN. FAU - Parker, Scott L AU - Parker SL AD - Department of Orthopedics Surgery and Department of Neurological Surgery, Spinal Column Surgical Quality and Outcomes Research Laboratory, Vanderbilt University Medical Center, Nashville, TN. FAU - Stonko, David P AU - Stonko DP AD - Department of Orthopedics Surgery and Department of Neurological Surgery, Spinal Column Surgical Quality and Outcomes Research Laboratory, Vanderbilt University Medical Center, Nashville, TN. FAU - Wick, Joseph B AU - Wick JB AD - Department of Orthopedics Surgery and Department of Neurological Surgery, Spinal Column Surgical Quality and Outcomes Research Laboratory, Vanderbilt University Medical Center, Nashville, TN. FAU - Hale, Andrew T AU - Hale AT AD - Department of Orthopedics Surgery and Department of Neurological Surgery, Spinal Column Surgical Quality and Outcomes Research Laboratory, Vanderbilt University Medical Center, Nashville, TN. FAU - McGirt, Matthew J AU - McGirt MJ AD - Department of Neurological Surgery, Carolina Neurosurgery and Spine Associates, Charlotte, NC. FAU - Cheng, Joseph S AU - Cheng JS AD - Department of Orthopedics Surgery and Department of Neurological Surgery, Spinal Column Surgical Quality and Outcomes Research Laboratory, Vanderbilt University Medical Center, Nashville, TN. AD - Department of Neurosurgery, Yale University, New Haven, CT. LA - eng PT - Journal Article PL - United States TA - Spine (Phila Pa 1976) JT - Spine JID - 7610646 SB - IM MH - Adult MH - Aged MH - Disability Evaluation MH - Female MH - Humans MH - Male MH - Middle Aged MH - Minimal Clinically Important Difference MH - *Pain Measurement/methods MH - Patient Reported Outcome Measures MH - Patient Satisfaction/statistics & numerical data MH - Prospective Studies MH - Quality of Life MH - Spinal Neoplasms/diagnosis/*surgery MH - Surveys and Questionnaires MH - Treatment Outcome EDAT- 2016/04/26 06:00 MHDA- 2017/09/07 06:00 CRDT- 2016/04/26 06:00 PHST- 2016/04/26 06:00 [pubmed] PHST- 2017/09/07 06:00 [medline] PHST- 2016/04/26 06:00 [entrez] AID - 00007632-201612150-00017 [pii] AID - 10.1097/BRS.0000000000001653 [doi] PST - ppublish SO - Spine (Phila Pa 1976). 2016 Dec 15;41(24):1925-1932. doi: 10.1097/BRS.0000000000001653.