PMID- 38317557
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240406
IS  - 2586-6583 (Print)
IS  - 2586-6591 (Electronic)
IS  - 2586-6591 (Linking)
VI  - 21
IP  - 1
DP  - 2024 Mar
TI  - Severe Preoperative Disability Is Associated With Greater Mental Health 
      Improvements Following Surgery for Degenerative Spondylolisthesis: A Cohort 
      Matched Analysis.
PG  - 253-260
LID - 10.14245/ns.2347080.540 [doi]
AB  - OBJECTIVE: To evaluate preoperative disability's influence on patient-reported 
      outcomes (PROs) following surgery for degenerative spondylolisthesis (DS). 
      METHODS: DS patients who underwent surgical intervention were retrospectively 
      identified from a single-surgeon spine registry. Cohorts based on Oswestry 
      Disability Index (ODI) < 41 (milder disability) and >/= 41 (severe disability) were 
      created. Demographic differences were accounted for with 1:1 propensity score 
      matching. For the matched sample, perioperative and PRO data were additionally 
      collected. PROs assessed included mental health, physical function, pain, and 
      disability. Pre- and up to 2-year postoperative PROs were utilized. Average time 
      to final follow-up was 15.7 +/- 8.8 months. Improvements in PROs and minimal 
      clinically important difference (MCID) rates were calculated. Continuous 
      variables were compared through Student t-test and categorical variables were 
      compared through chi-square tests. RESULTS: Altogether, 214 patients were 
      included with 77 in the milder disability group. The severe disability group had 
      worse postoperative day (POD) 1 pain scores and longer hospital stays (p </= 0.038, 
      both). The severe disability group reported worse outcomes pre- and 
      postoperatively (p < 0.011, all), but had greater average improvement in 12-item 
      Short Form health survey mental composite score (SF-12 MCS), 9-Item Patient 
      Health Questionnaire (PHQ-9), visual analogue scale (VAS)-back, and ODI by 6 
      weeks (p </= 0.037, all) and PHQ-9, VAS-back and ODI by final follow-up (p </= 0.015, 
      all). The severe disability cohort was more likely to achieve MCID for SF-12 MCS, 
      PHQ-9, and ODI (p </= 0.003, all). CONCLUSION: Patients with greater baseline 
      disability report higher POD 1 pain and discharge later than patients with milder 
      disability. While these patients report inferior physical/mental health before 
      and after surgery, they report greater improvements in mental health and 
      disability postoperatively.
FAU - Khosla, Ishan
AU  - Khosla I
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Anwar, Fatima N
AU  - Anwar FN
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Roca, Andrea M
AU  - Roca AM
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Medakkar, Srinath S
AU  - Medakkar SS
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Loya, Alexandra C
AU  - Loya AC
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Kaul, Aayush
AU  - Kaul A
AD  - Chicago Medical School at Rosalind Franklin University of Medicine and Science, 
      Chicago, IL, USA.
FAU - Wolf, Jacob C
AU  - Wolf JC
AD  - Chicago Medical School at Rosalind Franklin University of Medicine and Science, 
      Chicago, IL, USA.
FAU - Federico, Vincent P
AU  - Federico VP
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Sayari, Arash J
AU  - Sayari AJ
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Lopez, Gregory D
AU  - Lopez GD
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Singh, Kern
AU  - Singh K
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
LA  - eng
PT  - Journal Article
DEP - 20240131
PL  - Korea (South)
TA  - Neurospine
JT  - Neurospine
JID - 101724936
PMC - PMC10992647
OTO - NOTNLM
OT  - Degenerative spondylolisthesis
OT  - Disability
OT  - Mental health
OT  - Patient-reported outcomes
COIS- Conflict of Interest The authors have nothing to disclose.
EDAT- 2024/02/06 06:43
MHDA- 2024/02/06 06:44
PMCR- 2024/03/01
CRDT- 2024/02/06 02:36
PHST- 2023/10/14 00:00 [received]
PHST- 2023/12/11 00:00 [accepted]
PHST- 2024/02/06 06:44 [medline]
PHST- 2024/02/06 06:43 [pubmed]
PHST- 2024/02/06 02:36 [entrez]
PHST- 2024/03/01 00:00 [pmc-release]
AID - ns.2347080.540 [pii]
AID - ns-2347080-540 [pii]
AID - 10.14245/ns.2347080.540 [doi]
PST - ppublish
SO  - Neurospine. 2024 Mar;21(1):253-260. doi: 10.14245/ns.2347080.540. Epub 2024 Jan 
      31.