PMID- 38064702
OWN - NLM
STAT- MEDLINE
DCOM- 20240304
LR  - 20240304
IS  - 1547-5646 (Electronic)
IS  - 1547-5646 (Linking)
VI  - 40
IP  - 3
DP  - 2024 Mar 1
TI  - Risk factors for not reaching minimal clinically important difference at 90 days 
      and 1 year after elective lumbar spine surgery: a cohort study.
PG  - 343-350
LID - 10.3171/2023.9.SPINE23483 [doi]
AB  - OBJECTIVE: Patient-perceived functional improvement is a core metric in lumbar 
      surgery for degenerative disease. It is important to identify both modifiable and 
      nonmodifiable risk factors that can be evaluated and possibly optimized prior to 
      elective surgery. This case-control study was designed to study risk factors for 
      not achieving the minimal clinically important difference (MCID) in 
      Patient-Reported Outcomes Measurement Information System Function 4-item Short 
      Form (PROMIS PF) score. METHODS: The authors queried the Michigan Spine Surgery 
      Improvement Collaborative database to identify patients who underwent elective 
      lumbar surgical procedures with PROMIS PF scores. Cases were divided into two 
      cohorts based on whether patients achieved MCID at 90 days and 1 year after 
      surgery. Patient characteristics and operative details were analyzed as potential 
      risk factors. RESULTS: The authors captured 10,922 patients for 90-day follow-up 
      and 4453 patients (40.8%) did not reach MCID. At the 1-year follow-up period, 
      7780 patients were identified and 2941 patients (37.8%) did not achieve MCID. The 
      significant demographic characteristic-adjusted relative risks (RRs) for both 
      groups (RR 90 day, RR 1 year) included the following: symptom duration > 1 year 
      (1.34, 1.41); previous spine surgery (1.25, 1.30); African American descent 
      (1.25, 1.20); chronic opiate use (1.23, 1.25); and less than high school 
      education (1.20, 1.34). Independent ambulatory status (0.83, 0.88) and private 
      insurance (0.91, 0.85) were associated with higher likelihood of reaching MCID at 
      90 days and 1 year, respectively. CONCLUSIONS: Several key unique demographic 
      risk factors were identified in this cohort study that precluded optimal 
      postoperative functional outcomes after elective lumbar spine surgery. With this 
      information, appropriate preoperative counseling can be administered to assist in 
      shaping patient expectations.
FAU - Hamilton, Travis
AU  - Hamilton T
AD  - Departments of1Neurosurgery.
FAU - Lim, Seokchun
AU  - Lim S
AD  - Departments of1Neurosurgery.
FAU - Telemi, Edvin
AU  - Telemi E
AD  - Departments of1Neurosurgery.
FAU - Yun, Ho Jun
AU  - Yun HJ
AD  - 2Wayne State University School of Medicine, Detroit.
FAU - Macki, Mohamed
AU  - Macki M
AD  - Departments of1Neurosurgery.
FAU - Schultz, Lonni
AU  - Schultz L
AD  - 3Public Health Sciences.
FAU - Yeh, Hsueh-Han
AU  - Yeh HH
AD  - 4Center for Health Services Research, and.
FAU - Springer, Kylie
AU  - Springer K
AD  - 3Public Health Sciences.
FAU - Taliaferro, Kevin
AU  - Taliaferro K
AD  - 5Orthopedics, Henry Ford Hospital, Detroit.
FAU - Perez-Cruet, Miguelangelo
AU  - Perez-Cruet M
AD  - 6Department of Neurosurgery, William Beaumont Hospital, Royal Oak.
FAU - Aleem, Ilyas
AU  - Aleem I
AD  - Departments of7Orthopaedic Surgery and.
FAU - Park, Paul
AU  - Park P
AD  - 8Neurosurgery, University of Michigan, Ann Arbor; and.
FAU - Easton, Richard
AU  - Easton R
AD  - 9Department of Orthopedic Surgery, William Beaumont Hospital-Troy, Michigan.
FAU - Nerenz, David R
AU  - Nerenz DR
AD  - 4Center for Health Services Research, and.
FAU - Schwalb, Jason M
AU  - Schwalb JM
AD  - Departments of1Neurosurgery.
FAU - Abdulhak, Muwaffak
AU  - Abdulhak M
AD  - Departments of1Neurosurgery.
FAU - Chang, Victor
AU  - Chang V
AD  - Departments of1Neurosurgery.
LA  - eng
PT  - Journal Article
DEP - 20231208
PL  - United States
TA  - J Neurosurg Spine
JT  - Journal of neurosurgery. Spine
JID - 101223545
SB  - IM
MH  - Humans
MH  - *Black or African American
MH  - Case-Control Studies
MH  - Cohort Studies
MH  - *Minimal Clinically Important Difference
MH  - Risk Factors
MH  - *Spine/surgery
OTO - NOTNLM
OT  - disparities
OT  - lumbar spine
OT  - patient-reported outcomes
OT  - risk factors
OT  - spine registry
EDAT- 2023/12/08 18:42
MHDA- 2024/03/04 06:45
CRDT- 2023/12/08 16:53
PHST- 2023/05/03 00:00 [received]
PHST- 2023/09/28 00:00 [accepted]
PHST- 2024/03/04 06:45 [medline]
PHST- 2023/12/08 18:42 [pubmed]
PHST- 2023/12/08 16:53 [entrez]
AID - 10.3171/2023.9.SPINE23483 [doi]
PST - epublish
SO  - J Neurosurg Spine. 2023 Dec 8;40(3):343-350. doi: 10.3171/2023.9.SPINE23483. 
      Print 2024 Mar 1.