PMID- 35033696
OWN - NLM
STAT- MEDLINE
DCOM- 20220405
LR  - 20220823
IS  - 1878-8769 (Electronic)
IS  - 1878-8750 (Linking)
VI  - 160
DP  - 2022 Apr
TI  - Impact of Time to Surgery for Patients Using Workers' Compensation Insurance 
      Undergoing Minimally Invasive Transforaminal Lumbar Interbody Fusion: A 
      Preliminary Analysis of Clinical Outcomes.
PG  - e421-e429
LID - S1878-8750(22)00041-9 [pii]
LID - 10.1016/j.wneu.2022.01.038 [doi]
AB  - OBJECTIVE: To conduct a preliminary analysis on the impact of time to surgery 
      (TTS) and duration of symptoms (DOS) on clinical outcomes in workers' 
      compensation patients undergoing minimally invasive transforaminal lumbar 
      interbody fusion (MIS TLIF). METHODS: Patients using workers' compensation 
      insurance undergoing primary, single-level MIS TLIF were identified. 
      Patient-reported outcome measures (PROMs) were administered at 
      preoperative/6-week/12-week/6-month postoperative time points and included visual 
      analog scale (VAS) back/VAS leg/Oswestry Disability Index/12-Item Short-Form 
      Physical Composite Score/12-Item Short-Form Mental Composite Score. Patients were 
      grouped by TTS: <90 days, 90-179 days, and >/=180 days. Demographics were compared 
      by chi(2); perioperative characteristics, mean PROMs, and postoperative improvement 
      (DeltaPROM) were compared using 1-way analysis of variance. Minimum clinically 
      important difference (MCID) achievement rates were compared using simple logistic 
      regression. A secondary analysis was performed by grouping patients by DOS: <180 
      days, 180-364 days, and >/=365 days. Mean PROMs, DeltaPROMs, and MCID achievement were 
      similarly compared between DOS groups using 1-way analysis of variance and 
      logistic regression. RESULTS: A total of 193 patients were included. Prevalence 
      of herniated nucleus pulposus and initial appointment type were significantly 
      associated with TTS (P < 0.042, all). No significant differences in mean PROMs or 
      DeltaPROMs were observed among TTS groups. MCID achievement was significantly lower 
      for VAS back at 6 months in the longest TTS group. Mean PROMs were significantly 
      different based on DOS for VAS leg at 6 weeks only. MCID achievement was 
      significantly lower for the longest DOS group for VAS leg at 6 months only. 
      DeltaPROMs did not significantly differ among DOS groups. CONCLUSIONS: Neither TTS 
      nor DOS was significantly associated with MIS TLIF outcomes. Workers' 
      compensation patients may achieve similar clinical improvement even with longer 
      symptom burden and substantial delays in operative treatment.
CI  - Published by Elsevier Inc.
FAU - Patel, Madhav R
AU  - Patel MR
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Jacob, Kevin C
AU  - Jacob KC
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Lynch, Conor P
AU  - Lynch CP
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Cha, Elliot D K
AU  - Cha EDK
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Patel, Saajan D
AU  - Patel SD
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Prabhu, Michael C
AU  - Prabhu MC
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Vanjani, Nisheka N
AU  - Vanjani NN
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Pawlowski, Hanna
AU  - Pawlowski H
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Singh, Kern
AU  - Singh K
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA. Electronic address: kern.singh@rushortho.com.
LA  - eng
PT  - Journal Article
DEP - 20220113
PL  - United States
TA  - World Neurosurg
JT  - World neurosurgery
JID - 101528275
SB  - IM
MH  - Humans
MH  - *Insurance
MH  - Lumbar Vertebrae/surgery
MH  - Minimally Invasive Surgical Procedures
MH  - Patient Reported Outcome Measures
MH  - Retrospective Studies
MH  - *Spinal Fusion
MH  - Treatment Outcome
MH  - Workers' Compensation
OTO - NOTNLM
OT  - Duration of symptoms
OT  - Lumbar fusion
OT  - Patient-reported outcomes
OT  - Workers' compensation
EDAT- 2022/01/17 06:00
MHDA- 2022/04/06 06:00
CRDT- 2022/01/16 20:50
PHST- 2021/11/23 00:00 [received]
PHST- 2022/01/09 00:00 [revised]
PHST- 2022/01/09 00:00 [accepted]
PHST- 2022/01/17 06:00 [pubmed]
PHST- 2022/04/06 06:00 [medline]
PHST- 2022/01/16 20:50 [entrez]
AID - S1878-8750(22)00041-9 [pii]
AID - 10.1016/j.wneu.2022.01.038 [doi]
PST - ppublish
SO  - World Neurosurg. 2022 Apr;160:e421-e429. doi: 10.1016/j.wneu.2022.01.038. Epub 
      2022 Jan 13.