PMID- 37488399
OWN - NLM
STAT- MEDLINE
DCOM- 20230905
LR  - 20231012
IS  - 0942-0940 (Electronic)
IS  - 0001-6268 (Linking)
VI  - 165
IP  - 9
DP  - 2023 Sep
TI  - Time to achievement of minimum clinically important difference after lumbar 
      decompression.
PG  - 2625-2631
LID - 10.1007/s00701-023-05709-0 [doi]
AB  - OBJECTIVE: The objective of this study is to examine factors associated with 
      delayed time to achieve minimum clinically important difference (MCID) in 
      patients undergoing lumbar decompression (LD) for the Patient-Reported Outcomes 
      (PROs) of Oswestry Disability Index (ODI), Visual Analog Scale (VAS) back, and 
      VAS leg pain. METHODS: Patients undergoing LD with preoperative and postoperative 
      ODI, VAS back, and VAS leg scores were retrospectively reviewed from April 2016 
      to January 2021. MCID values from previously established studies were utilized to 
      determine MCID achievement. Kaplan-Meier survival analysis determined the time to 
      achieve MCID. Hazard ratios from multivariable Cox regression were utilized to 
      determine the preoperative factors predictive of MCID achievement. RESULTS: 
      Three-hundred and forty-three patients were identified undergoing LD. Overall 
      MCID achievement rates were 67.4% for ODI, 67.1% for VAS back, and 65.0% for VAS 
      leg. The mean time in weeks for MCID achievement was 22.52 +/- 30.48 for ODI, 
      18.90 +/- 27.43 for VAS back, and 20.96 +/- 29.81 for VAS leg. Multivariable Cox 
      regression revealed active smoker status, preoperative Patient-Reported Outcomes 
      Measurement Information System Physical Function (PROMIS-PF), ODI, VAS Back, and 
      VAS Leg (HR 1.03-2.14) as predictors of early MCID achievement, whereas an 
      American Society of Anesthesiologist (ASA) classification of 2, Black ethnicity, 
      workers' compensation, private insurance, and diagnosis of foraminal stenosis 
      were predictors of late MCID achievement (HR 0.34-0.58). CONCLUSION: Most 
      patients undergoing LD achieved MCID within 6 months of surgery. Significant 
      factors for early MCID achievement were active smoking status and baseline PROs. 
      Significant factors for late MCID achievement were ASA = 2, Black ethnicity, type 
      of insurance, and foraminal stenosis diagnosis. These factors may be considered 
      by surgeons in setting patient expectations.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, 
      part of Springer Nature.
FAU - Nie, James W
AU  - Nie JW
AUID- ORCID: 0000-0002-6680-009X
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. 
      Harrison St. Suite #300, Chicago, IL, 60612, USA.
FAU - Federico, Vincent P
AU  - Federico VP
AUID- ORCID: 0000-0003-3749-9282
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. 
      Harrison St. Suite #300, Chicago, IL, 60612, USA.
FAU - Hartman, Timothy J
AU  - Hartman TJ
AUID- ORCID: 0000-0003-3937-3480
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. 
      Harrison St. Suite #300, Chicago, IL, 60612, USA.
FAU - Zheng, Eileen
AU  - Zheng E
AUID- ORCID: 0000-0002-2444-6790
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. 
      Harrison St. Suite #300, Chicago, IL, 60612, USA.
FAU - Oyetayo, Omolabake O
AU  - Oyetayo OO
AUID- ORCID: 0000-0002-6098-7121
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. 
      Harrison St. Suite #300, Chicago, IL, 60612, USA.
FAU - MacGregor, Keith R
AU  - MacGregor KR
AUID- ORCID: 0000-0003-4557-828X
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. 
      Harrison St. Suite #300, Chicago, IL, 60612, USA.
FAU - Massel, Dustin H
AU  - Massel DH
AUID- ORCID: 0000-0002-8147-5555
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. 
      Harrison St. Suite #300, Chicago, IL, 60612, USA.
FAU - Sayari, Arash J
AU  - Sayari AJ
AUID- ORCID: 0000-0001-6450-2438
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. 
      Harrison St. Suite #300, Chicago, IL, 60612, USA.
FAU - Singh, Kern
AU  - Singh K
AUID- ORCID: 0000-0002-6118-7273
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. 
      Harrison St. Suite #300, Chicago, IL, 60612, USA. kern.singh@rushortho.com.
LA  - eng
PT  - Journal Article
DEP - 20230724
PL  - Austria
TA  - Acta Neurochir (Wien)
JT  - Acta neurochirurgica
JID - 0151000
SB  - IM
MH  - Humans
MH  - Treatment Outcome
MH  - Retrospective Studies
MH  - Constriction, Pathologic
MH  - *Pain
MH  - *Spinal Fusion
MH  - Lumbar Vertebrae/surgery
MH  - Decompression
OTO - NOTNLM
OT  - Lumbar decompression
OT  - Minimum clinically important difference
OT  - Patient-reported outcomes
EDAT- 2023/07/25 01:09
MHDA- 2023/09/05 06:42
CRDT- 2023/07/24 23:33
PHST- 2023/04/28 00:00 [received]
PHST- 2023/06/29 00:00 [accepted]
PHST- 2023/09/05 06:42 [medline]
PHST- 2023/07/25 01:09 [pubmed]
PHST- 2023/07/24 23:33 [entrez]
AID - 10.1007/s00701-023-05709-0 [pii]
AID - 10.1007/s00701-023-05709-0 [doi]
PST - ppublish
SO  - Acta Neurochir (Wien). 2023 Sep;165(9):2625-2631. doi: 
      10.1007/s00701-023-05709-0. Epub 2023 Jul 24.