PMID- 34266930
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210827
IS  - 2211-4599 (Print)
IS  - 2211-4599 (Electronic)
IS  - 2211-4599 (Linking)
VI  - 15
IP  - 4
DP  - 2021 Aug
TI  - Charlson Comorbidity Index: An Inaccurate Predictor of Minimally Invasive Lumbar 
      Spinal Fusion Outcomes.
PG  - 770-779
LID - 10.14444/8099 [doi]
AB  - BACKGROUND: There is a scarcity of research on the Charlson Comorbidity Index 
      (CCI) and its influence on minimum clinically important difference (MCID) 
      achievement after minimally invasive (MIS) transforaminal lumbar interbody fusion 
      (TLIF). The objective of this study is to detail the association between the CCI 
      and attaining MCID after MIS TLIF. METHODS: A prospective surgical registry was 
      retrospectively reviewed for spine surgeries between May 2015 and February 2019. 
      Inclusion criteria were primary or revision, 1- or 2-level MIS TLIF procedures. 
      Patients were stratified based on CCI score: 0 points (no comorbidities), 1-2 
      points (mild CCI), >/=3 points (moderate CCI). Preoperative, intraoperative, and 
      postoperative variables were assessed by subgroup using appropriate statistical 
      analysis. Subgroups were analyzed with linear regression or chi(2) tests for 
      continuous or categorical variables, respectively. Subgroup scores, improvement, 
      and MCID achievement were assessed at postoperative timepoints (eg, 6 weeks, 12 
      weeks, 6 months, and 1 year) for back and leg pain, Oswestry Disability Index 
      (ODI), SF-12 Physical Composite Score (PCS), and Patient-Reported Outcomes 
      Measurement Information System Physical Function (PROMIS PF). RESULTS: A total of 
      171 patients were included (n = 51 [no comorbidities], n = 73 [mild CCI], and n = 
      47 [moderate CCI]). Higher CCI patients were older and more likely to be smokers, 
      diabetic, arthritic, hypertensive, or have a malignancy history (P < 0.003). 
      Preoperatively, ODI and PROMIS PF were the only patient-reported outcomes with a 
      significant association by CCI group (P = 0.015 and 0.014). Back pain was the 
      only measure that had a significant association with the CCI subgroup at 1 year 
      for score (P = 0.002) or MCID (P = 0.028). CONCLUSIONS: By 1 year, regardless of 
      the number of comorbidities, a similar proportion of patients undergoing MIS TLIF 
      were able to achieve MCID for visual analog scale leg, SF-12 PCS, and PROMIS PF. 
      Patients with higher comorbidities are not likely to experience a significant 
      difference in symptom improvement. Regardless of CCI score, MIS TLIF can have a 
      significant benefit for patients. LEVEL OF EVIDENCE: 4. CLINICAL RELEVANCE: Text.
CI  - This manuscript is generously published free of charge by ISASS, the 
      International Society for the Advancement of Spine Surgery. Copyright (c) 2021 
      ISASS.
FAU - Jenkins, Nathaniel W
AU  - Jenkins NW
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois.
FAU - Parrish, James M
AU  - Parrish JM
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois.
FAU - Nolte, Michael T
AU  - Nolte MT
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois.
FAU - Jadczak, Caroline N
AU  - Jadczak CN
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois.
FAU - Geoghegan, Cara E
AU  - Geoghegan CE
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois.
FAU - Mohan, Shruthi
AU  - Mohan S
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois.
FAU - Hrynewycz, Nadia M
AU  - Hrynewycz NM
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois.
FAU - Singh, Kern
AU  - Singh K
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois.
LA  - eng
PT  - Journal Article
DEP - 20210715
PL  - Netherlands
TA  - Int J Spine Surg
JT  - International journal of spine surgery
JID - 101579005
PMC - PMC8375692
OTO - NOTNLM
OT  - PROMIS
OT  - Patient-Reported Outcomes Measurement Information System
OT  - minimal clinically important difference
OT  - minimally invasive transforaminal interbody fusion
OT  - spine surgery
COIS- Disclosures and COI: No funds were received in support of this work. No benefits 
      in any form have been or will be received from any commercial party related 
      directly or indirectly to the subject of this manuscript. IRB Approval: ORA No. 
      14051301.
EDAT- 2021/07/17 06:00
MHDA- 2021/07/17 06:01
PMCR- 2021/08/19
CRDT- 2021/07/16 05:52
PHST- 2021/07/17 06:00 [pubmed]
PHST- 2021/07/17 06:01 [medline]
PHST- 2021/07/16 05:52 [entrez]
PHST- 2021/08/19 00:00 [pmc-release]
AID - 8099 [pii]
AID - 10.14444/8099 [doi]
PST - ppublish
SO  - Int J Spine Surg. 2021 Aug;15(4):770-779. doi: 10.14444/8099. Epub 2021 Jul 15.