PMID- 32707556
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240517
IS  - 1547-5646 (Electronic)
IS  - 1547-5646 (Linking)
VI  - 33
IP  - 5
DP  - 2020 Jul 24
TI  - Effects of preoperative obesity and psychiatric comorbidities on minimum 
      clinically important differences for lumbar fusion in grade 1 degenerative 
      spondylolisthesis: analysis from the prospective Quality Outcomes Database 
      registry.
PG  - 635-642
LID - 10.3171/2020.4.SPINE20296 [doi]
AB  - OBJECTIVE: Medical comorbidities, particularly preoperatively diagnosed anxiety, 
      depression, and obesity, may influence how patients perceive and measure clinical 
      benefit after a surgical intervention. The current study was performed to define 
      and compare the minimum clinically important difference (MCID) thresholds in 
      patients with and without preoperative diagnoses of anxiety or depression and 
      obesity who underwent spinal fusion for grade 1 degenerative spondylolisthesis. 
      METHODS: The Quality Outcomes Database (QOD) was queried for patients who 
      underwent lumbar fusion for grade 1 degenerative spondylolisthesis during the 
      period from January 2014 to August 2017. Collected patient-reported outcomes 
      (PROs) included the Oswestry Disability Index (ODI), health status (EQ-5D), and 
      numeric rating scale (NRS) scores for back pain (NRS-BP) and leg pain (NRS-LP). 
      Both anchor-based and distribution-based methods for MCID calculation were 
      employed. RESULTS: Of 462 patients included in the prospective registry who 
      underwent a decompression and fusion procedure, 356 patients (77.1%) had complete 
      baseline and 12-month PRO data and were included in the study. The MCID values 
      for ODI scores did not significantly differ in patients with and those without a 
      preoperative diagnosis of obesity (20.58 and 20.69, respectively). In addition, 
      the MCID values for ODI scores did not differ in patients with and without a 
      preoperative diagnosis of anxiety or depression (24.72 and 22.56, respectively). 
      Similarly, the threshold MCID values for NRS-BP, NRS-LP, and EQ-5D scores were 
      not statistically different between all groups. Based on both anchor-based and 
      distribution-based methods for determination of MCID thresholds, there were no 
      statistically significant differences between all cohorts. CONCLUSIONS: MCID 
      thresholds were similar for ODI, EQ-5D, NRS-BP, and NRS-LP in patients with and 
      without preoperative diagnoses of anxiety or depression and obesity undergoing 
      spinal fusion for grade 1 degenerative spondylolisthesis. Preoperative clinical 
      and shared decision-making may be improved by understanding that preoperative 
      medical comorbidities may not affect the way patients experience and assess 
      important clinical changes postoperatively.
FAU - Laratta, Joseph
AU  - Laratta J
AD  - 1Norton Leatherman Spine Center, Louisville, Kentucky.
FAU - Carreon, Leah Y
AU  - Carreon LY
AD  - 1Norton Leatherman Spine Center, Louisville, Kentucky.
FAU - Buchholz, Avery L
AU  - Buchholz AL
AD  - 2Department of Neurosurgery, University of Virginia, Charlottesville, Virginia.
FAU - Yew, Andrew Y
AU  - Yew AY
AD  - 3Department of Neurosurgery, Lahey Hospital and Medical Center, Burlington, 
      Massachusetts.
FAU - Bisson, Erica F
AU  - Bisson EF
AD  - 4Department of Neurosurgery, University of Utah Health Care, Salt Lake City, 
      Utah; and.
FAU - Mummaneni, Praveen V
AU  - Mummaneni PV
AD  - 5Department of Neurosurgery, University of California, San Francisco Medical 
      Center-Spine Center, San Francisco, California.
FAU - Glassman, Steven D
AU  - Glassman SD
AD  - 1Norton Leatherman Spine Center, Louisville, Kentucky.
LA  - eng
PT  - Journal Article
DEP - 20200724
PL  - United States
TA  - J Neurosurg Spine
JT  - Journal of neurosurgery. Spine
JID - 101223545
SB  - IM
OTO - NOTNLM
OT  - BMI
OT  - MCID
OT  - QOD
OT  - Quality Outcomes Database
OT  - anxiety
OT  - degenerative
OT  - depression
OT  - fusion
OT  - lumbar spine
OT  - minimum clinically important difference
OT  - obesity
OT  - spondylolisthesis
EDAT- 2020/07/25 06:00
MHDA- 2020/07/25 06:01
CRDT- 2020/07/25 06:00
PHST- 2020/03/01 00:00 [received]
PHST- 2020/04/30 00:00 [accepted]
PHST- 2020/07/25 06:01 [medline]
PHST- 2020/07/25 06:00 [pubmed]
PHST- 2020/07/25 06:00 [entrez]
AID - 2020.4.SPINE20296 [pii]
AID - 10.3171/2020.4.SPINE20296 [doi]
PST - epublish
SO  - J Neurosurg Spine. 2020 Jul 24;33(5):635-642. doi: 10.3171/2020.4.SPINE20296.