PMID- 31503049
OWN - NLM
STAT- MEDLINE
DCOM- 20210927
LR  - 20210927
IS  - 2380-0194 (Electronic)
IS  - 2380-0186 (Linking)
VI  - 33
IP  - 6
DP  - 2020 Jul
TI  - The Effect of Preoperative Symptom Duration on Postoperative Outcomes After 
      Minimally Invasive Transforaminal Lumbar Interbody Fusion.
PG  - E263-E268
LID - 10.1097/BSD.0000000000000881 [doi]
AB  - STUDY DESIGN: Retrospective. OBJECT: This study aims to examine whether the time 
      spanning from symptom onset to surgical intervention has an effect on 
      postoperative clinical improvement in patients undergoing minimally invasive 
      transforaminal lumbar interbody fusion (MIS TLIF). SUMMARY OF BACKGROUND DATA: 
      Evidence is limited regarding the influence of preoperative symptom duration on 
      patient-reported outcomes (PROs). METHODS: Patients undergoing a primary, 
      single-level minimally invasive transforaminal lumbar interbody fusion were 
      retrospectively reviewed and stratified according to preoperative symptom 
      duration (<12 mo and >/=12 mo). Differences in PROs, including Oswestry Disability 
      Index (ODI), 12-Item Short-Form Physical Component Score (SF-12 PCS), Visual 
      Analogue Scale (VAS) back pain, and VAS leg pain, at each postoperative timepoint 
      and were compared between duration of symptoms (DOS) cohorts using linear 
      regression. Achievement of minimal clinically important difference (MCID) for 
      PROs was compared using chi analysis. RESULTS: A total of 248 patients were 
      included: 96 had a DOS <12 months and 152 had a DOS >12 months. When comparing 
      PROs preoperatively, the shorter DOS cohort had significantly worse ODI, VAS leg 
      pain, and SF-12 PCS compared with patients with longer DOS. However, there was no 
      preoperative difference in VAS back pain between cohorts. Postoperatively, there 
      were no significant differences in improvement of PROs throughout the 12-month 
      timepoint. The shorter DOS cohort had a comparable number of patients achieving 
      MCID for ODI, VAS back pain, VAS leg pain, and SF-12 PCS relative to the longer 
      DOS cohort. CONCLUSIONS: In our study, patients with DOS <12 months exhibited 
      significantly worse ODI and VAS leg pain scores at the time of surgery compared 
      with patients with longer DOS. However, these patients demonstrated similar 
      clinical improvement postoperatively regardless of preoperative symptom duration. 
      These findings suggest that delayed surgical intervention may not lead to 
      impaired functional recovery in patients with degenerative lumbar disease.
FAU - Yoo, Joon S
AU  - Yoo JS
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.
FAU - Patel, Dillon S
AU  - Patel DS
FAU - Hrynewycz, Nadia M
AU  - Hrynewycz NM
FAU - Brundage, Thomas S
AU  - Brundage TS
FAU - Mogilevsky, Franchesca A
AU  - Mogilevsky FA
FAU - Singh, Kern
AU  - Singh K
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Clin Spine Surg
JT  - Clinical spine surgery
JID - 101675083
SB  - IM
MH  - Aged
MH  - Female
MH  - Humans
MH  - Intervertebral Disc Degeneration/*surgery
MH  - Lumbar Vertebrae/*surgery
MH  - Lumbosacral Region/*surgery
MH  - Male
MH  - Middle Aged
MH  - Minimally Invasive Surgical Procedures
MH  - Pain Measurement
MH  - Patient Reported Outcome Measures
MH  - Postoperative Period
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Spinal Fusion/*adverse effects
MH  - Spondylolisthesis/*surgery
MH  - Symptom Assessment
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2019/09/11 06:00
MHDA- 2021/09/28 06:00
CRDT- 2019/09/11 06:00
PHST- 2019/09/11 06:00 [pubmed]
PHST- 2021/09/28 06:00 [medline]
PHST- 2019/09/11 06:00 [entrez]
AID - 01933606-202007000-00010 [pii]
AID - 10.1097/BSD.0000000000000881 [doi]
PST - ppublish
SO  - Clin Spine Surg. 2020 Jul;33(6):E263-E268. doi: 10.1097/BSD.0000000000000881.