PMID- 34990539
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221213
IS  - 2586-6583 (Print)
IS  - 2586-6591 (Electronic)
IS  - 2586-6591 (Linking)
VI  - 19
IP  - 3
DP  - 2022 Sep
TI  - Higher American Society of Anesthesiologists Classification Does Not Limit Safety 
      or Improvement Following Minimally Invasive Transforaminal Lumbar Interbody 
      Fusion.
PG  - 533-543
LID - 10.14245/ns.2142088.044 [doi]
AB  - OBJECTIVE: The American Society of Anesthesiologists (ASA) physical status 
      classification has been used to risk stratify surgical candidates. Our study 
      compares outcomes of minimally invasive transforaminal lumbar interbody fusion 
      (MIS TLIF) procedures based on preoperative ASA physical status classification. 
      METHODS: A surgical registry was reviewed for primary, single-level MIS TLIF 
      patients. Patients were categorized by preoperative ASA physical status 
      classification: ASA I, ASA II, ASA III+. Perioperative complications were 
      compared among groups. Patient-reported outcome measures (PROMs) for back pain, 
      leg pain, physical function, and disability were recorded preoperatively and at 
      6-week, 12-week, 6-month, 1-year, and 2-year postoperative timepoints. PROM 
      improvement from baseline (DeltaPROM) and minimum clinically important difference 
      (MCID) achievement was calculated for each timepoint and compared among groups. 
      MCID achievement was determined as DeltaPROMs that surpassed previously established 
      MCID values. RESULTS: Of the 487 patients, 64 had an ASA classification of I, 
      whereas 336 had an ASA of II, and 87 had an ASA of III or greater. Rates of 
      complications were not associated with ASA classification (all p > 0.050). 
      Neither mean PROM scores nor DeltaPROM scores were significantly associated with ASA 
      classification at any timepoint (all p > 0.050). MCID achievement was 
      significantly associated with ASA classification for back pain at 1 year only (p 
      = 0.041). Overall MCID achievement was not significantly associated with ASA 
      classification for any PROM (p > 0.050). CONCLUSION: While ASA classification has 
      been commonly used to risk stratify surgical candidates for spinal procedures, 
      patients with an ASA of III or greater may be able to achieve similar long-term 
      outcomes following MIS TLIF given proper selection criteria.
FAU - Lynch, Conor P
AU  - Lynch CP
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Cha, Elliot D K
AU  - Cha EDK
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Geoghegan, Cara E
AU  - Geoghegan CE
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Jadczak, Caroline N
AU  - Jadczak CN
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Mohan, Shruthi
AU  - Mohan S
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Singh, Kern
AU  - Singh K
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
LA  - eng
PT  - Journal Article
DEP - 20220102
PL  - Korea (South)
TA  - Neurospine
JT  - Neurospine
JID - 101724936
PMC - PMC9537840
OTO - NOTNLM
OT  - Anesthesiologist
OT  - Minimally invasive surgery
OT  - Patient-reported outcomes
OT  - Transforaminal lumbar interbody fusion
COIS- Conflict of Interest The authors have nothing to disclose.
EDAT- 2022/01/07 06:00
MHDA- 2022/01/07 06:01
PMCR- 2022/09/01
CRDT- 2022/01/06 18:28
PHST- 2021/01/21 00:00 [received]
PHST- 2021/04/28 00:00 [accepted]
PHST- 2022/01/07 06:00 [pubmed]
PHST- 2022/01/07 06:01 [medline]
PHST- 2022/01/06 18:28 [entrez]
PHST- 2022/09/01 00:00 [pmc-release]
AID - ns.2142088.044 [pii]
AID - ns-2142088-044 [pii]
AID - 10.14245/ns.2142088.044 [doi]
PST - ppublish
SO  - Neurospine. 2022 Sep;19(3):533-543. doi: 10.14245/ns.2142088.044. Epub 2022 Jan 
      2.