PMID- 35843537 OWN - NLM STAT- MEDLINE DCOM- 20221216 LR - 20230207 IS - 1878-1632 (Electronic) IS - 1529-9430 (Linking) VI - 23 IP - 1 DP - 2023 Jan TI - Practical answers to frequently asked questions in minimally invasive lumbar spine surgery. PG - 54-63 LID - S1529-9430(22)00788-4 [pii] LID - 10.1016/j.spinee.2022.07.087 [doi] AB - BACKGROUND CONTEXT: Surgical counseling enables shared decision-making (SDM) by improving patients' understanding. PURPOSE: To provide answers to frequently asked questions (FAQs) in minimally invasive lumbar spine surgery. STUDY DESIGN: Retrospective review of prospectively collected data. PATIENT SAMPLE: Patients who underwent primary tubular minimally invasive lumbar spine surgery in form of transforaminal lumbar interbody fusion (MI-TLIF), decompression alone, or microdiscectomy and had a minimum of 1-year follow-up. OUTCOME MEASURES: (1) Surgical (radiation exposure and intraoperative complications) (2)Immediate postoperative (length of stay [LOS] and complications) (3) Clinical outcomes (Visual Analog Scale- back and leg, VAS; Oswestry Disability Index, ODI; 12-Item Short Form Survey Physical Component Score, SF-12 PCS; Patient-Reported Outcomes Measurement Information System Physical Function, PROMIS PF; Global Rating Change, GRC; return to activities; complications/reoperations) METHODS: The outcome measures were analyzed to provide answers to ten FAQs that were compiled based on the authors' experience and a review of literature. Changes in VAS back, VAS leg, ODI, and SF-12 PCS from preoperative values to the early (<6 months) and late (>6 months) postoperative time points were analyzed with Wilcoxon Signed Rank Tests. % of patients achieving minimal clinically important difference (MCID) for these patient-reported outcome measures (PROMs) at the two time points was evaluated. Changes in PROs from preoperative values too early (<6 months) and late (>/=6 months) postoperative time points were analyzed within each of the three groups. Percentage of patients achieving MCID was also evaluated. RESULTS: Three hundred sixty-six patients (104 TLIF, 147 decompression, 115 microdiscectomy) were included. The following FAQs were answered: (1) Will my back pain improve? Most patients report improvement by >50%. About 60% of TLIF, decompression, and microdiscectomy patients achieved MCID at >/=6 months. (2) Will my leg pain improve? Most patients report improvement by >50%. 56% of TLIF, 67% of decompression, and 70% of microdiscectomy patients achieved MCID at >/=6 months. (3) Will my activity level improve? Most patients report significant improvement. Sixty-six percent of TLIF, 55% of decompression, and 75% of microdiscectomy patients achieved MCID for SF-12 PCS. (4) Is there a chance I will get worse? Six percent after TLIF, 14% after decompression, and 5% after microdiscectomy. (5) Will I receive a significant amount of radiation? The radiation exposure is likely to be acceptable and nearly insignificant in terms of radiation-related risks. (6) What is the likelihood that I will have a complication? 17.3% (15.4% minor, 1.9% major) for TLIF, 10% (9.3% minor and 0.7% major) for decompression, and 1.7% (all minor) for microdiscectomy (7) Will I need another surgery? Six percent after TLIF, 16.3% after decompression, 13% after microdiscectomy. (8) How long will I stay in the hospital? Most patients get discharged on postoperative day one after TLIF and on the same day after decompression and microdiscectomy. (9) When will I be able to return to work? >80% of patients return to work (average: 25 days after TLIF, 14 days after decompression, 11 days after microdiscectomy). (10) Will I be able to drive again? >90% of patients return to driving (average: 22 days after TLIF, 11 days after decompression, 14 days after microdiscectomy). CONCLUSIONS: These concise answers to the FAQs in minimally invasive lumbar spine surgery can be used by physicians as a reference to enable patient education. CI - Copyright (c) 2022 Elsevier Inc. All rights reserved. FAU - Shahi, Pratyush AU - Shahi P AD - Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E. 70th St., New York, NY, USA. FAU - Vaishnav, Avani S AU - Vaishnav AS AD - Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E. 70th St., New York, NY, USA. FAU - Mai, Eric AU - Mai E AD - Department of Orthopaedic Surgery, Weill Cornell Medicine, New York, NY , USA. FAU - Kim, Jeong Hoon AU - Kim JH AD - Department of Orthopaedic Surgery, Weill Cornell Medicine, New York, NY , USA. FAU - Dalal, Sidhant AU - Dalal S AD - Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E. 70th St., New York, NY, USA. FAU - Song, Junho AU - Song J AD - Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E. 70th St., New York, NY, USA. FAU - Shinn, Daniel J AU - Shinn DJ AD - Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E. 70th St., New York, NY, USA. FAU - Melissaridou, Dimitra AU - Melissaridou D AD - Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E. 70th St., New York, NY, USA. FAU - Araghi, Kasra AU - Araghi K AD - Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E. 70th St., New York, NY, USA. FAU - Urakawa, Hikari AU - Urakawa H AD - Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E. 70th St., New York, NY, USA. FAU - Sivaganesan, Ahilan AU - Sivaganesan A AD - Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E. 70th St., New York, NY, USA. FAU - Lafage, Virginie AU - Lafage V AD - Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E. 70th St., New York, NY, USA. FAU - Qureshi, Sheeraz A AU - Qureshi SA AD - Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E. 70th St., New York, NY, USA; Department of Orthopaedic Surgery, Weill Cornell Medicine, New York, NY , USA. Electronic address: qureshis@hss.edu. FAU - Iyer, Sravisht AU - Iyer S AD - Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E. 70th St., New York, NY, USA; Department of Orthopaedic Surgery, Weill Cornell Medicine, New York, NY , USA. LA - eng GR - UL1 TR002384/TR/NCATS NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Review DEP - 20220715 PL - United States TA - Spine J JT - The spine journal : official journal of the North American Spine Society JID - 101130732 SB - IM MH - Humans MH - *Lumbar Vertebrae/surgery MH - *Spinal Fusion/adverse effects MH - Treatment Outcome MH - Lumbosacral Region/surgery MH - Minimally Invasive Surgical Procedures/adverse effects MH - Retrospective Studies OTO - NOTNLM OT - Decompression OT - Frequently asked questions OT - Minimally invasive lumbar spine surgery OT - Patient-reported outcomes OT - Shared decision-making OT - Transforaminal lumbar interbody fusion OT - Tubular microdiscectomy COIS- Declarations of Competing Interests One or more of the authors declare financial or professional relationships on ICMJE-NASSJ disclosure forms. EDAT- 2022/07/18 06:00 MHDA- 2022/12/17 06:00 CRDT- 2022/07/17 19:28 PHST- 2022/03/30 00:00 [received] PHST- 2022/06/03 00:00 [revised] PHST- 2022/07/11 00:00 [accepted] PHST- 2022/07/18 06:00 [pubmed] PHST- 2022/12/17 06:00 [medline] PHST- 2022/07/17 19:28 [entrez] AID - S1529-9430(22)00788-4 [pii] AID - 10.1016/j.spinee.2022.07.087 [doi] PST - ppublish SO - Spine J. 2023 Jan;23(1):54-63. doi: 10.1016/j.spinee.2022.07.087. Epub 2022 Jul 15.