PMID- 37054388
OWN - NLM
STAT- MEDLINE
DCOM- 20230818
LR  - 20230818
IS  - 1940-5480 (Electronic)
IS  - 1067-151X (Linking)
VI  - 31
IP  - 17
DP  - 2023 Sep 1
TI  - The Influence of Workers' Compensation Status on Patient-Reported Outcomes after 
      Cervical Disc Arthroplasty at an Ambulatory Surgical Center.
PG  - e657-e664
LID - 10.5435/JAAOS-D-22-00892 [doi]
AB  - INTRODUCTION: Workers' compensation (WC) status tends to negatively affect 
      patient outcomes in spine surgery. This study aims to evaluate the potential 
      effect of WC status on patient-reported outcomes (PROs) after cervical disc 
      arthroplasty (CDR) at an ambulatory surgical center (ASC). METHODS: A 
      single-surgeon registry was retrospectively reviewed for patients who had 
      undergone elective CDR at an ASC. Patients with missing insurance data were 
      excluded. Propensity score-matched cohorts were generated by the presence or lack 
      of WC status. PROs were collected preoperatively and at 6-week, 12-week, 6-month, 
      and 1-year time points. PROs included the Patient-Reported Outcomes Measurement 
      Information System Physical Function (PROMIS-PF), visual analog scale (VAS) neck 
      and arm pain, and Neck Disability Index. PROs were compared within and between 
      groups. Minimum clinically important difference (MCID) achievement rates were 
      compared between groups. RESULTS: Sixty-three patients were included, with 36 
      without WC (non-WC) and 27 with WC. The non-WC cohort demonstrated postoperative 
      improvement in all PROs at all time points, with the exception of VAS arm past 
      the 12-week point ( P </= 0.030, all). The WC cohort demonstrated postoperative 
      improvement in VAS neck at 12-week, 6-month, and 1-year time points ( P </= 0.025, 
      all). The WC cohort improved in VAS arm and Neck Disability Index at the 12-week 
      and 1-year points as well ( P </= 0.029, all). The non-WC cohort reported superior 
      PRO scores in every PRO at one or more postoperative time points ( P </= 0.046, 
      all). The non-WC cohort demonstrated higher rates of minimum clinically important 
      difference achievement in PROMIS-PF at 12 weeks ( P </= 0.024). CONCLUSION: 
      Patients with WC status undergoing CDR at an ASC may report inferior pain, 
      function, and disability outcomes compared with those with private or 
      government-provided insurance. Perceived inferior disability in WC patients 
      persisted into the long-term follow-up period (1 year). These findings may aid 
      surgeons in setting realistic preoperative expectations with patients at risk of 
      inferior outcomes.
CI  - Copyright (c) 2023 by the American Academy of Orthopaedic Surgeons.
FAU - Hartman, Timothy J
AU  - Hartman TJ
AD  - From the Department of Orthopaedic Surgery, Rush University Medical Center, 
      Chicago, IL.
FAU - Nie, James W
AU  - Nie JW
FAU - Zheng, Eileen
AU  - Zheng E
FAU - Oyetayo, Omolabake O
AU  - Oyetayo OO
FAU - MacGregor, Keith R
AU  - MacGregor KR
FAU - Singh, Kern
AU  - Singh K
AUID- ORCID: 0000-0002-6118-7273
LA  - eng
PT  - Journal Article
DEP - 20230412
PL  - United States
TA  - J Am Acad Orthop Surg
JT  - The Journal of the American Academy of Orthopaedic Surgeons
JID - 9417468
SB  - IM
MH  - Humans
MH  - *Workers' Compensation
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Arthroplasty
MH  - Pain/etiology
MH  - Patient Reported Outcome Measures
MH  - *Spinal Fusion/adverse effects
EDAT- 2023/04/14 06:00
MHDA- 2023/08/18 06:43
CRDT- 2023/04/13 17:12
PHST- 2022/10/08 00:00 [received]
PHST- 2023/03/12 00:00 [accepted]
PHST- 2023/08/18 06:43 [medline]
PHST- 2023/04/14 06:00 [pubmed]
PHST- 2023/04/13 17:12 [entrez]
AID - 00124635-990000000-00664 [pii]
AID - 10.5435/JAAOS-D-22-00892 [doi]
PST - ppublish
SO  - J Am Acad Orthop Surg. 2023 Sep 1;31(17):e657-e664. doi: 
      10.5435/JAAOS-D-22-00892. Epub 2023 Apr 12.