PMID- 35177523
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221013
IS  - 2211-4599 (Print)
IS  - 2211-4599 (Electronic)
IS  - 2211-4599 (Linking)
VI  - 16
IP  - 1
DP  - 2022 Feb
TI  - Risk Factors for Failing to Reach a Minimal Clinically Important Difference 
      Following Minimally Invasive Lumbar Decompression.
PG  - 51-61
LID - 10.14444/8176 [doi]
AB  - BACKGROUND: Clinically important postoperative changes can be best evaluated 
      through the minimal clinically important difference (MCID). Our study aims to 
      evaluate risk factors associated with failure to achieve MCID following lumbar 
      decompression (LD). METHODS: Demographics, perioperative characteristics, and 
      patient-reported outcome measures (PROM) for pain, disability, and physical 
      function were retrospectively reviewed and collected for patients undergoing LD. 
      MCID achievement was calculated using established values. Relative risk of 
      demographic and perioperative characteristics with failure to meet MCID for all 
      PROMs was calculated. Least absolute shrinkage and selection operator (LASSO) was 
      used to estimate individual risk factors, and postestimation logistic regression 
      was performed. RESULTS: The study cohort included 811 patients. Comorbidity 
      burden was associated with failed MCID for visual analog scale (VAS) back and leg 
      pain and Oswestry Disability Index (ODI). Operative levels or duration was 
      associated with failed MCID for VAS leg pain, 12-item short form physical 
      component summary (SF-12 PCS), and the patient-reported outcomes measurement 
      information system physical function (PROMIS PF). Preoperative spinal pathology 
      was associated with failed MCID for VAS leg pain, ODI, SF-12 PCS, and PROMIS PF. 
      Additional risk factors included the type of operation, insurance, age, and body 
      mass index. LASSO selected insurance, age, comorbidity burden, blood loss, 
      operative duration, and type of spinal pathology as significant risk factors for 
      failure to reach MCID. CONCLUSION: Failure to reach MCID was greatest for VAS 
      back. Age, comorbidity burden, and prolonged procedures were significantly 
      associated with risk for failure to reach MCID for a majority of PROMs. 
      Comorbidity burden combined with operative outcomes may place patients at 
      increased risk for failure to reach MCID for pain, disability, and physical 
      function following LD. CLINICAL RELEVANCE: Establishes risk factors for failing 
      to reach the threshold of meaningful difference in symptoms after LD surgery.
CI  - This manuscript is generously published free of charge by ISASS, the 
      International Society for the Advancement of Spine Surgery. Copyright (c) 2022 
      ISASS. To see more or order reprints or permissions, see http://ijssurgery.com.
FAU - Cha, Elliot D K
AU  - Cha EDK
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Lynch, Conor P
AU  - Lynch CP
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 kern.singh@rushortho.com.
LA  - eng
PT  - Journal Article
DEP - 20220217
PL  - Netherlands
TA  - Int J Spine Surg
JT  - International journal of spine surgery
JID - 101579005
PMC - PMC9519070
OTO - NOTNLM
OT  - lumbar decompression
OT  - minimal clinically important difference
OT  - outcomes
EDAT- 2022/02/19 06:00
MHDA- 2022/02/19 06:01
PMCR- 2022/02/15
CRDT- 2022/02/18 05:42
PHST- 2022/02/19 06:00 [pubmed]
PHST- 2022/02/19 06:01 [medline]
PHST- 2022/02/18 05:42 [entrez]
PHST- 2022/02/15 00:00 [pmc-release]
AID - 8176 [pii]
AID - IJSSURGERY-D-20-00421 [pii]
AID - 10.14444/8176 [doi]
PST - ppublish
SO  - Int J Spine Surg. 2022 Feb;16(1):51-61. doi: 10.14444/8176. Epub 2022 Feb 17.