PMID- 30296576
OWN - NLM
STAT- MEDLINE
DCOM- 20200305
LR  - 20200305
IS  - 1878-1632 (Electronic)
IS  - 1529-9430 (Linking)
VI  - 19
IP  - 4
DP  - 2019 Apr
TI  - Patient-reported outcomes unbiased by length of follow-up after lumbar 
      degenerative spine surgery: Do we need 2 years of follow-up?
PG  - 637-644
LID - S1529-9430(18)31160-4 [pii]
LID - 10.1016/j.spinee.2018.10.004 [doi]
AB  - BACKGROUND: In modern clinical research, the accepted minimum follow-up for 
      patient-reported outcome measures (PROMs) after lumbar spine surgery is 24 
      months, particularly after fusion. Recently, this minimum requirement has been 
      called into question. PURPOSE: We aim to quantify the concordance of 1- and 
      2-year PROMs to evaluate the importance of long-term follow-up after elective 
      lumbar spine surgery. STUDY DESIGN: Retrospective analysis of data from a 
      prospective registry. PATIENT SAMPLE: We identified all patients in our 
      prospective institutional registry who underwent degenerative lumbar spine 
      surgery with complete baseline, 12-month, and 24-month follow-up for ODI and 
      numeric rating scales for back and leg pain (NRS-BP and NRS-LP). OUTCOME 
      MEASURES: Oswestry Disability Index (ODI) and NRS-BP and NRS-LP at 1 year and at 
      2 years. METHODS: We evaluated concordance of 1- and 2-year change scores by 
      means of Pearson's product-moment correlation and performed logistic regression 
      to assess if achieving the minimum clinically important difference (MCID) at 12 
      months predicted 24-month MCID. Odds ratios (OR) and their 95% confidence 
      intervals (CI), as well as model areas-under-the-curve were obtained. RESULTS: A 
      total of 210 patients were included. We observed excellent correlation among 12- 
      and 24-month ODI (r = 0.88), NRS-LP (r = 0.76) and NRS-BP (r = 0.72, all p 
      <.001). Equal results were obtained when stratifying for discectomy, 
      decompression, or fusion. Patients achieving 12-month MCID were likely to achieve 
      24-month MCID for ODI (OR: 3.3, 95% CI: 2.4-4.1), NRS-LP (OR: 2.99, 95% CI: 
      2.2-4.2) and NRS-BP (OR: 3.4, 95% CI: 2.7-4.2, all p <.001) with excellent 
      areas-under-the-curve values of 0.81, 0.77, and 0.84, respectively. Concordance 
      rates between MCID at both follow-ups were 87.2%, 83.8%, and 84.2%. A post-hoc 
      power analysis demonstrated sufficient statistical power. CONCLUSIONS: 
      Irrespective of the surgical procedure, 12-month PROMs for functional disability 
      and pain severity accurately reflect those at 24 months. In support of previous 
      literature, our results suggest that 12 months of follow-up may be sufficient for 
      evaluating spinal patient care in clinical practice as well as in research.
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Staartjes, Victor E
AU  - Staartjes VE
AD  - Department of Neurosurgery, Bergman Clinics Amsterdam, Naarden, Rijksweg 69, 1411 
      GE, Naarden, The Netherlands; Faculty of Medicine, University of Zurich, Zurich, 
      Switzerland. Electronic address: victor.staartjes@gmail.com.
FAU - Siccoli, Alessandro
AU  - Siccoli A
AD  - Faculty of Medicine, University of Zurich, Zurich, Switzerland.
FAU - de Wispelaere, Marlies P
AU  - de Wispelaere MP
AD  - Department of Clinical Informatics, Bergman Clinics Amsterdam, Naarden, The 
      Netherlands.
FAU - Schroder, Marc L
AU  - Schroder ML
AD  - Department of Neurosurgery, Bergman Clinics Amsterdam, Naarden, Rijksweg 69, 1411 
      GE, Naarden, The Netherlands.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20181005
PL  - United States
TA  - Spine J
JT  - The spine journal : official journal of the North American Spine Society
JID - 101130732
SB  - IM
CIN - Spine J. 2019 Sep;19(9):1598. PMID: 31175993
CIN - Spine J. 2019 Sep;19(9):1597. PMID: 31443845
MH  - Adult
MH  - Aftercare/standards
MH  - Aged
MH  - Decompression, Surgical/*adverse effects
MH  - Elective Surgical Procedures/*adverse effects
MH  - Female
MH  - Humans
MH  - Lumbar Vertebrae/*surgery
MH  - Male
MH  - Middle Aged
MH  - *Patient Reported Outcome Measures
MH  - Postoperative Complications/*epidemiology
OTO - NOTNLM
OT  - Decompression
OT  - Degenerative
OT  - Discectomy
OT  - Fusion
OT  - Outcome measurement
OT  - Patient-reported outcomes
EDAT- 2018/10/09 06:00
MHDA- 2020/03/07 06:00
CRDT- 2018/10/09 06:00
PHST- 2018/04/23 00:00 [received]
PHST- 2018/10/02 00:00 [revised]
PHST- 2018/10/03 00:00 [accepted]
PHST- 2018/10/09 06:00 [pubmed]
PHST- 2020/03/07 06:00 [medline]
PHST- 2018/10/09 06:00 [entrez]
AID - S1529-9430(18)31160-4 [pii]
AID - 10.1016/j.spinee.2018.10.004 [doi]
PST - ppublish
SO  - Spine J. 2019 Apr;19(4):637-644. doi: 10.1016/j.spinee.2018.10.004. Epub 2018 Oct 
      5.