PMID- 37821028 OWN - NLM STAT- MEDLINE DCOM- 20231221 LR - 20231221 IS - 1878-8769 (Electronic) IS - 1878-8750 (Linking) VI - 180 DP - 2023 Dec TI - The Veterans Rand-12 Physical Composite Score Prognosticates Postoperative Clinical Outcomes in Patients Undergoing Anterior Cervical Discectomy and Fusion. PG - e756-e764 LID - S1878-8750(23)01425-0 [pii] LID - 10.1016/j.wneu.2023.10.020 [doi] AB - OBJECTIVE: To determine prognostic value of preoperative Veterans RAND 12-Item Health Survey (VR-12) physical composite score (PCS) on outcomes in patients undergoing anterior cervical discectomy and fusion (ACDF). METHODS: ACDF patients with preoperative VR-12 PCS formed 2 cohorts: VR-12 PCS <35 and VR-12 PCS >/=35. The following patient-reported outcome measures (PROMs) were gathered preoperatively and postoperatively up to 2 years: VR-12 mental composite score (MCS)/PCS, Neck Disability Index (NDI), Patient-Reported Outcomes Measurement Information System (PROMIS) PF, 9-Item Patient Health Questionnaire (PHQ-9), visual analog scale (VAS) neck/arm pain, and 12-Item Short Form Health Survey (SF-12) PCS/MCS. Comparing PROMs change with established thresholds determined achievement of minimum clinically important difference (MCID). Univariate analysis compared demographics, perioperative characteristics, and preoperative PROMs. Multivariable regression analysis compared postoperative PROMs and MCID achievement. RESULTS: Of 174 patients, 83 had VR-12 PCS <35. Preoperatively, patients with reduced PF displayed lower patient-reported outcome scores in NDI, PHQ-9, and SF-12 MCS (P 0.05). Greater improvements at 6 weeks postoperatively were especially noted in patients with lower initial VR-12 PCS for NDI, PROMIS PF, and SF-12 PCS (P < 0.05). However, by final follow-up, only PROMIS PF showed noteworthy improvement (P = 0.19). Regarding MCID achievement, significant differences were largely absent except in NDI, where patients with reduced PF exhibited more MCID achievement (P = 0.016). CONCLUSIONS: ACDF patients with VR-12 PCS <35 experienced inferior PF, mental health, and disability postoperatively until final follow-up. There were no significant differences in postoperative improvement magnitude and MCID achievement. Results suggest that baseline VR-12 PCS in ACDF patients may indicate poorer PF, mental health, and disability postoperatively. However, VR-12 PCS does not limit extent of postoperative improvement. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Roca, Andrea M AU - Roca AM AD - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA. FAU - Anwar, Fatima N AU - Anwar FN AD - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA. FAU - Loya, Alexandra C AU - Loya AC AD - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA. FAU - Medakkar, Srinath S AU - Medakkar SS AD - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA. FAU - Kaul, Aayush AU - Kaul A AD - Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA. FAU - Wolf, Jacob C AU - Wolf JC AD - Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA. FAU - Khosla, Ishan AU - Khosla I AD - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA. FAU - Federico, Vincent P AU - Federico VP AD - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA. FAU - Sayari, Arash J AU - Sayari AJ AD - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA. FAU - Lopez, Gregory D AU - Lopez GD AD - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA. FAU - Singh, Kern AU - Singh K AD - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA. Electronic address: kern.singh@rushortho.com. LA - eng PT - Journal Article DEP - 20231028 PL - United States TA - World Neurosurg JT - World neurosurgery JID - 101528275 SB - IM MH - Humans MH - Treatment Outcome MH - *Veterans MH - Cervical Vertebrae/surgery MH - *Spinal Fusion/methods MH - Neck Pain/etiology MH - Diskectomy/methods OTO - NOTNLM OT - ACDF OT - Outcomes OT - PROMs OT - VR-12 PCS EDAT- 2023/10/12 00:43 MHDA- 2023/12/21 06:42 CRDT- 2023/10/11 19:41 PHST- 2023/08/04 00:00 [received] PHST- 2023/10/03 00:00 [revised] PHST- 2023/10/04 00:00 [accepted] PHST- 2023/12/21 06:42 [medline] PHST- 2023/10/12 00:43 [pubmed] PHST- 2023/10/11 19:41 [entrez] AID - S1878-8750(23)01425-0 [pii] AID - 10.1016/j.wneu.2023.10.020 [doi] PST - ppublish SO - World Neurosurg. 2023 Dec;180:e756-e764. doi: 10.1016/j.wneu.2023.10.020. Epub 2023 Oct 28.