PMID- 37347591
OWN - NLM
STAT- MEDLINE
DCOM- 20231003
LR  - 20231003
IS  - 1547-5646 (Electronic)
IS  - 1547-5646 (Linking)
VI  - 39
IP  - 4
DP  - 2023 Oct 1
TI  - Association of prolonged symptom duration with poor outcomes in lumbar spine 
      surgery: a Michigan Spine Surgery Improvement Collaborative study.
PG  - 452-461
LID - 10.3171/2023.5.SPINE23249 [doi]
AB  - OBJECTIVE: There is a scarcity of large multicenter data on how preoperative 
      lumbar symptom duration relates to postoperative patient-reported outcomes 
      (PROs). The objective of this study was to determine the effect of preoperative 
      and baseline symptom duration on PROs at 90 days, 1 year, and 2 years after 
      lumbar spine surgery. METHODS: The Michigan Spine Surgery Improvement 
      Collaborative registry was queried for all lumbar spine operations between 
      January 1, 2017, to December 31, 2021, with a follow-up of 2 years. Patients were 
      stratified into three subgroups based on symptom duration: < 3 months, 3 months 
      to < 1 year, and >/= 1 year. The primary outcomes were reaching the minimal 
      clinically important difference (MCID) for the PROs (i.e., leg pain, 
      Patient-Reported Outcomes Measurement Information System Physical Function 
      (PROMIS PF), EQ-5D, North American Spine Society satisfaction, and return to 
      work). The EQ-5D score was also analyzed as a continuous variable to calculate 
      quality-adjusted life years. Multivariable Poisson generalized estimating 
      equation models were used to report adjusted risk ratios, with the < 3-month 
      cohort used as the reference. RESULTS: There were 37,223 patients (4670 with < 
      3-month duration, 9356 with 3-month to < 1-year duration, and 23,197 with >/= 
      1-year duration) available for analysis. Compared with patients with a symptom 
      duration of < 1 year, patients with a symptom duration of >/= 1 year were 
      significantly less likely to achieve an MCID in PROMIS PF, EQ-5D, back pain 
      relief, and leg pain relief at 90 days, 1 year, and 2 years postoperatively. 
      Similar trends were observed for patient satisfaction and return to work. With 
      the EQ-5D score as a continuous variable, a symptom duration of >/= 1 year was 
      associated with 0.04, 0.05, and 0.03 (p < 0.001) decreases in EQ-5D score at 90 
      days, 1 year, and 2 years after surgery, respectively. CONCLUSIONS: A symptom 
      duration of >/= 1 year was associated with poorer outcomes on several outcome 
      metrics. This suggests that timely referral and surgery for degenerative lumbar 
      pathology may optimize patient outcome.
FAU - Hamilton, Travis
AU  - Hamilton T
AD  - Departments of1Neurosurgery and.
FAU - Bartlett, Seamus
AU  - Bartlett S
AD  - 4Wayne State University School of Medicine, Detroit, Michigan.
FAU - Deshpande, Nachiket
AU  - Deshpande N
AD  - 5Michigan State University College of Human Medicine, East Lansing, Michigan.
FAU - Hadi, Moustafa
AU  - Hadi M
AD  - 5Michigan State University College of Human Medicine, East Lansing, Michigan.
FAU - Reese, Jared C
AU  - Reese JC
AD  - Departments of1Neurosurgery and.
FAU - Mansour, Tarek R
AU  - Mansour TR
AD  - Departments of1Neurosurgery and.
FAU - Telemi, Edvin
AU  - Telemi E
AD  - Departments of1Neurosurgery and.
FAU - Springer, Kylie
AU  - Springer K
AD  - 2Public Health Sciences and.
FAU - Schultz, Lonni
AU  - Schultz L
AD  - 2Public Health Sciences and.
FAU - Nerenz, David R
AU  - Nerenz DR
AD  - 3Center for Health Services Research, Henry Ford Health, Detroit, Michigan.
FAU - Abdulhak, Muwaffak
AU  - Abdulhak M
AD  - Departments of1Neurosurgery and.
FAU - Soo, Teck
AU  - Soo T
AD  - 6Division of Neurosurgery, Ascension Providence Hospital, Farmington Hills, 
      Michigan.
FAU - Schwalb, Jason
AU  - Schwalb J
AD  - Departments of1Neurosurgery and.
FAU - Khalil, Jad G
AU  - Khalil JG
AD  - Departments of7Orthopedics and.
FAU - Aleem, Ilyas
AU  - Aleem I
AD  - Departments of8Orthopedics and.
FAU - Easton, Richard
AU  - Easton R
AD  - 9Department of Orthopedics, Beaumont Troy Hospital, Troy, Michigan.
FAU - Perez-Cruet, Miguelangelo
AU  - Perez-Cruet M
AD  - 10Neurosurgery, Beaumont Royal Oak Hospital, Royal Oak, Michigan.
FAU - Park, Paul
AU  - Park P
AD  - 11Neurosurgery, University of Michigan, Ann Arbor, Michigan; and.
FAU - Chang, Victor
AU  - Chang V
AD  - Departments of1Neurosurgery and.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20230616
PL  - United States
TA  - J Neurosurg Spine
JT  - Journal of neurosurgery. Spine
JID - 101223545
SB  - IM
MH  - Humans
MH  - Treatment Outcome
MH  - Michigan/epidemiology
MH  - *Spine
MH  - *Patient Satisfaction
MH  - Pain
MH  - Lumbar Vertebrae/surgery
OTO - NOTNLM
OT  - lumbar spine
OT  - patient-reported outcomes
OT  - symptom duration
OT  - time to surgery
EDAT- 2023/06/22 19:15
MHDA- 2023/10/03 06:47
CRDT- 2023/06/22 12:13
PHST- 2023/03/06 00:00 [received]
PHST- 2023/05/09 00:00 [accepted]
PHST- 2023/10/03 06:47 [medline]
PHST- 2023/06/22 19:15 [pubmed]
PHST- 2023/06/22 12:13 [entrez]
AID - 10.3171/2023.5.SPINE23249 [doi]
PST - epublish
SO  - J Neurosurg Spine. 2023 Jun 16;39(4):452-461. doi: 10.3171/2023.5.SPINE23249. 
      Print 2023 Oct 1.