PMID- 34699995 OWN - NLM STAT- MEDLINE DCOM- 20220329 LR - 20230402 IS - 1878-1632 (Electronic) IS - 1529-9430 (Print) IS - 1529-9430 (Linking) VI - 22 IP - 4 DP - 2022 Apr TI - Do preoperative clinical and radiographic characteristics impact patient outcomes following one-level minimally invasive transforaminal lumbar interbody fusion based upon presenting symptoms? PG - 570-577 LID - S1529-9430(21)00973-6 [pii] LID - 10.1016/j.spinee.2021.10.013 [doi] AB - BACKGROUND CONTEXT: Patients undergoing minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) frequently present with lower extremity neurologic symptoms with or without associated lower back pain. While symptomatic improvement of leg and back pain has been reported, the resolution of back pain when it is a predominant presenting symptom remains underreported following MI-TLIF. PURPOSE: The purpose of this study was to compare clinical outcomes at 1 year of patients undergoing MI-TLIF with lower extremity neurologic symptoms with and without a significant component of back pain. STUDY DESIGN: A retrospective review of prospectively collected data from a single surgeon surgical database from 2017 to 2019 was performed. PATIENT SAMPLE: Fifty one patients undergoing MI-TLIF. OUTCOME MEASURES: Self-reported measures included the Oswestry Disability Index (ODI), Visual analog scale back pain (VAS-back), and VAS leg pain (VAS-leg). METHODS: Patients were divided into two groups: Leg Pain Predominant (patients reported greater than 50% leg pain upon presentation) and Back Pain Predominant (patients reported 50% or greater back pain). Multivariate analysis was performed to determine differences between groups based upon any significantly baseline characteristics. RESULTS: Preoperative demographic and radiographic outcomes were similar between the two groups. Both groups demonstrated significant improvement in ODI, VAS-Back and VAS-leg at 1-year postoperatively. On multivariate analysis, there were differences in ODI at 1-year, 1-year back pain, and 1-year leg pain between groups with those who initially presented with leg pain having a lower ODI, VAS Back, and VAS leg. Patients who presented with predominantly leg pain were more likely to meet minimal clinically important difference (MCID) criteria for ODI and VAS-back compared to those with predominantly back pain. CONCLUSION: Following MI-TLIF, patients with lower extremity neurologic symptoms with and without a significant component of back pain have improvements in back pain, leg pain, and ODI regardless of their primary presenting pain complaint; however, patients who presented with predominantly leg pain were more likely to meet MCID criteria for improvement in their back pain and ODI score. CI - Copyright (c) 2021 Elsevier Inc. All rights reserved. FAU - Morse, Kyle W AU - Morse KW AD - Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA. FAU - Alluri, Ram K AU - Alluri RK AD - Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA. FAU - Vaishnav, Avani S AU - Vaishnav AS AD - Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA. FAU - Urakawa, Hikari AU - Urakawa H AD - Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA. FAU - Mok, Jung Kee AU - Mok JK AD - Department of Orthopedic Surgery, Weill Cornell Medical College, 1300 York Ave, New York, NY 10065, USA. FAU - Virk, Sohrab S AU - Virk SS AD - Department of Orthopedic Surgery, North Shore University Hospital, 300 Community Dr, Manhasset, NY, USA; Department of Orthopedic Surgery, Long Island Jewish Medical Center, 825 Northern Blvd, Great Neck, NY, USA. FAU - Sheha, Evan D AU - Sheha ED AD - Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA; Department of Orthopedic Surgery, Weill Cornell Medical College, 1300 York Ave, New York, NY 10065, USA. FAU - Qureshi, Sheeraz A AU - Qureshi SA AD - Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA; Department of Orthopedic Surgery, Weill Cornell Medical College, 1300 York Ave, New York, NY 10065, USA. Electronic address: sheerazqureshimd@gmail.com. LA - eng GR - T32 AR078751/AR/NIAMS NIH HHS/United States GR - UL1 TR002384/TR/NCATS NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20211023 PL - United States TA - Spine J JT - The spine journal : official journal of the North American Spine Society JID - 101130732 SB - IM MH - Back Pain/etiology/surgery MH - Humans MH - *Lumbar Vertebrae/surgery MH - Minimally Invasive Surgical Procedures MH - Retrospective Studies MH - *Spinal Fusion/adverse effects MH - Treatment Outcome PMC - PMC9178522 MID - NIHMS1759981 OTO - NOTNLM OT - Back pain OT - Interbody fusion OT - Leg pain OT - Low Back Pain OT - MCID OT - Minimally invasive surgery OT - Postoperative back pain OT - Postoperative leg pain OT - Radicular Pain OT - TLIF COIS- Conflicts of Interest: The authors report no conflicts of interest relevant to the topic of this study. EDAT- 2021/10/27 06:00 MHDA- 2022/03/30 06:00 PMCR- 2023/04/01 CRDT- 2021/10/26 20:15 PHST- 2021/07/30 00:00 [received] PHST- 2021/09/13 00:00 [revised] PHST- 2021/10/12 00:00 [accepted] PHST- 2021/10/27 06:00 [pubmed] PHST- 2022/03/30 06:00 [medline] PHST- 2021/10/26 20:15 [entrez] PHST- 2023/04/01 00:00 [pmc-release] AID - S1529-9430(21)00973-6 [pii] AID - 10.1016/j.spinee.2021.10.013 [doi] PST - ppublish SO - Spine J. 2022 Apr;22(4):570-577. doi: 10.1016/j.spinee.2021.10.013. Epub 2021 Oct 23.