PMID- 28973581
OWN - NLM
STAT- MEDLINE
DCOM- 20180619
LR  - 20180620
IS  - 1524-4040 (Electronic)
IS  - 0148-396X (Linking)
VI  - 81
IP  - 6
DP  - 2017 Dec 1
TI  - Establishing Minimal Clinically Important Difference of Spinal Cord Stimulation 
      Therapy in Post-Laminectomy Syndrome.
PG  - 1011-1015
LID - 10.1093/neuros/nyx153 [doi]
AB  - BACKGROUND: The concept of minimum clinically important difference (MCID) has 
      been shown to be effective in spine surgery to differentiate between clinically 
      insignificant and significant improvements as determined by the patient. 
      OBJECTIVE: The MCID for spinal cord stimulation (SCS) to date has not been 
      established. We sought to determine the MCID for SCS therapy for failed 
      laminectomy syndromes. METHODS: Preoperative and 6-mo outcomes were assessed 
      prospectively, including the Oswestry Disability Index (ODI), Beck Depression 
      Inventory (BDI), and McGill and Visual Analog Survey questionnaires. Patients 
      were asked: (1) are you satisfied with SCS therapy and (2) would you have the 
      surgery again. Four methods of calculating the MCID were utilized. RESULTS: 
      Forty-eight patients who underwent placement of an SCS between 2012 and 2014 were 
      reviewed. The 4 calculation methods yielded a range of outcome scores (ODI 
      8.2-13.3, BDI 3.2-7, McGill 0.3-1.3, and Visual Analog Scale [VAS] 1.2-3.7). The 
      maximum area under the curve was observed for the ODI, BDI, and VAS (0.73, 0.81, 
      and 0.89, respectively), which signifies acceptable accuracy in distinguishing 
      responders from nonresponders with the receiver operating characteristic method 
      and suggests that VAS may be the most sensitive in determining meaningful change 
      for the patient. CONCLUSION: The MCID for SCS placement was calculated using 4 
      different methods. The results are similar to calculations for the MCID for many 
      lumbar and cervical procedures done for pain. Our results suggest that an 
      improvement of 1.2 to 3.7 points on the VAS scale and 8.2 to 13.3 points on the 
      ODI is clinically meaningful to the patient. Further defining the MCID for SCS 
      therapy will remain of utmost importance in order to justify the cost of the 
      procedure.
CI  - Copyright (c) 2017 by the Congress of Neurological Surgeons
FAU - Paul, Alexandra R
AU  - Paul AR
AD  - Department of Neurosurgery, Albany Medical Center, Albany, New York.
FAU - Kumar, Vignessh
AU  - Kumar V
AD  - Department of Neurosurgery, Albany Medical Center, Albany, New York.
FAU - Roth, Steven
AU  - Roth S
AD  - Department of Neurosurgery, Albany Medical Center, Albany, New York.
FAU - Gooch, M Reid
AU  - Gooch MR
AD  - Department of Neurosurgery, Albany Medical Center, Albany, New York.
FAU - Pilitsis, Julie G
AU  - Pilitsis JG
AD  - Department of Neurosurgery, Albany Medical Center, Albany, New York.
AD  - Center for Neuroscience and Neuropharmacology, Albany Medical College, Albany, 
      New York.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Neurosurgery
JT  - Neurosurgery
JID - 7802914
SB  - IM
MH  - Adult
MH  - Aged
MH  - Disability Evaluation
MH  - Failed Back Surgery Syndrome/*therapy
MH  - Female
MH  - Humans
MH  - Laminectomy/*adverse effects
MH  - Lumbosacral Region
MH  - Male
MH  - Middle Aged
MH  - *Minimal Clinically Important Difference
MH  - Pain Measurement/methods
MH  - Spinal Cord Stimulation/*methods
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Failed back surgery syndrome
OT  - MCID
OT  - Metrics
OT  - Outcome
OT  - SCS
EDAT- 2017/10/04 06:00
MHDA- 2018/06/21 06:00
CRDT- 2017/10/04 06:00
PHST- 2015/06/01 00:00 [received]
PHST- 2017/06/06 00:00 [accepted]
PHST- 2017/10/04 06:00 [pubmed]
PHST- 2018/06/21 06:00 [medline]
PHST- 2017/10/04 06:00 [entrez]
AID - 3884538 [pii]
AID - 10.1093/neuros/nyx153 [doi]
PST - ppublish
SO  - Neurosurgery. 2017 Dec 1;81(6):1011-1015. doi: 10.1093/neuros/nyx153.