PMID- 35177529
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  - Differences in Clinically Important Physical Function Improvement in Workers' 
      Compensation Population.
PG  - 176-185
LID - 10.14444/8186 [doi]
AB  - BACKGROUND: Patients receiving workers' compensation demonstrate a propensity for 
      poorer postoperative outcomes. This study aims to determine rates of minimum 
      clinically important difference (MCID) achievement in patients receiving workers' 
      compensation following transforaminal lumbar interbody fusion (TLIF). METHODS: We 
      retrospectively reviewed a prospective surgical database from 2015 to 2020 for 
      primary, single-level TLIFs with posterior instrumentation for degenerative 
      spinal pathologies. Visual analog scale (VAS) for back and leg, Oswestry 
      Disability Index (ODI), 12-Item Short Form Physical Component Summary (SF-12 
      PCS), and Patient-Reported Outcome Measurement Information System physical 
      function (PROMIS-PF) were collected pre- and postoperatively. Patients were 
      separated by workers' compensation (WC) status. Propensity score matching was 
      performed to account for differences in demographic characteristics. 
      Postoperative improvements in patient-reported outcome measures (PROMs) were 
      calculated using paired Student's t test, and intergroup differences were 
      determined by Mann-Whitney U test. Achievement of MCID was determined using 
      established values, and intergroup differences were assessed using chi (2) 
      analysis. RESULTS: A total of 121 patients were included in this study with 29 WC 
      and 92 non-WC patients. The mean age was 53.5 years with the majority being men 
      (63.6%) and nonobese (54.5%). WC patients demonstrated significantly poorer PROM 
      values at all timepoints except for preoperative VAS back (P = 0.297) and leg (P 
      = 0.475). Overall achievement of MCID was significantly lower for WC patients for 
      VAS back (P = 0.040), ODI (P = 0.001), SF-12 PCS (P = 0.010), and PROMIS-PF (P = 
      0.039). CONCLUSION: WC patients demonstrated poorer postoperative outcomes at 
      multiple timepoints. Additionally, a significantly lower rate of MCID achievement 
      for back pain, disability, and physical function was observed for WC patients. 
      CLINICAL RELEVANCE: These results suggest that WC patients may require 
      alternative preoperative counseling about realistic expectations for improvement 
      following lumbar fusion.
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 - 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 - Geoghegan, Cara E
AU  - Geoghegan CE
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 - PMC9519079
OTO - NOTNLM
OT  - lumbar fusion
OT  - patient-reported outcome measures (PROMs)
OT  - propensity score match
OT  - workers' compensation
COIS- Declaration of Conflicting Interests: Kern Singh discloses that he has received 
      grants or contracts from the Cervical Spine Research Society; royalties or 
      licenses from RTI Surgical, Zimmer Biomet, Stryker, Lippincott Williams & 
      Wilkins, Theime, Jaypee Publishing, and Slack Publishing; consulting fees from 
      K2M and Zimmer Biomet; patents planned, issued, or pending with TDi LLC; and 
      leadership or fiduciary role on Vitals 5 LLC, TDi LLC, Minimally Invasive Spine 
      Study Group, Contemporary Spine Surgery, Orthopedics Today, and Vertebral 
      Columns. The remaining authors have no disclosures.
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 - 8186 [pii]
AID - IJSSURGERY-D-21-00014 [pii]
AID - 10.14444/8186 [doi]
PST - ppublish
SO  - Int J Spine Surg. 2022 Feb;16(1):176-185. doi: 10.14444/8186. Epub 2022 Feb 17.