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Little research has been done to evaluate the prognostic value of short-term postoperative patient-reported outcomes (PROs) on long-term PROs following lumbar decompression (LD). We evaluated the prognostic value of short-term PROs on long-term PROs through 2 years after LD. A single spine surgeon database was retrospectively queried for patients undergoing primary LD with 6-week postoperative PROs reported. The demographics, perioperative traits, and preoperative, 6-month, 1-year, and 2-year PROs were recorded. The PROs included the visual analog scale (VAS) for back pain, VAS for leg pain, PRO measure information system for physical function (PROMIS-PF), and Oswestry disability index. Two-step multivariate linear regression was performed to determine the predictive value of 6-week PROs for the 6-month, 1-year, and 2-year PROs. A total of 277 patients were included. The 6-week Oswestry disability index, VAS for leg pain, and 9-item patient health questionnaire (PHQ-9) are all positive predictors for their respective outcomes at 6 months. Additionally, the 6-week PROMIS-PF was a negative predictor of the 6-month PHQ-9. The 6-week PROMIS-PF positively predicted the PROMIS-PF through 1 year, and the PHQ-9 was a positive predictor of the PHQ-9 at 1 and 2 years postoperatively. The 6-week postoperative PROs are predictive of the same outcomes at 6 months, the PROMIS-PF is predictive through 1 year, and the PHQ-9 is predictive through 2 years. Determining the predictive value of early postoperative PROs can be helpful in understanding the likely postoperative trajectory following LD and informing patient expectations. [ABSTRACT FROM AUTHOR]

To examine the impact of Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance (PROMIS-SD) on clinical outcomes in patients undergoing lumbar decompression. Patients undergoing lumbar decompression with preoperative PROMIS-SD scores were retrospectively included. Patients were separated into 2 cohorts: none to slight sleep disturbance (PROMIS-SD <55) and mild to severe sleep disturbance (PROMIS-SD ≥55). Patient-reported outcome measures including PROMIS Physical Function, PROMIS Anxiety, PROMIS Pain Interference, PROMIS SD, 9-item Patient Health Questionnaire, visual analog scale back/leg, and Oswestry Disability Index were collected preoperatively and up to 1 year postoperatively. Of 87 patients identified, 48 patients had PROMIS-SD scores ≥55. Regardless of preoperative PROMIS-SD score, patients reported significant improvement in physical function, anxiety, pain interference, depression, pain, and disability outcomes in at least 1 time point. Patients in the PROMIS-SD ≥55 cohort reported postoperative improvement in sleep disturbance. Patients in the PROMIS-SD <55 cohort reported superior preoperative patient-reported outcome measures in all domains and superior postoperative improvement in pain interference and sleep disturbance. Minimum clinically important difference attainment rates were higher in the PROMIS-SD ≥55 cohort in physical function, anxiety, pain interference, sleep disturbance, and pain. Patients undergoing lumbar decompression demonstrated significant postoperative improvement in most clinical outcomes regardless of preoperative sleep disturbance. Patients with mild to severe sleep disturbance had higher minimum clinically important difference attainment rates for physical function, mental function, and pain. Patients undergoing lumbar decompression with greater preoperative sleep disturbance may experience more clinically noticeable improvement. [ABSTRACT FROM AUTHOR]

Newer Patient-Reported Outcomes (PROs) may offer benefits over legacy PROs in ease of administration and interpretation. We aim to study the influence of preoperative pain interference (PI) using the Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference (PROMIS-PI) on postoperative clinical outcomes in patients undergoing lumbar decompression. Patients undergoing lumbar decompression without fusion were separated into 2 cohorts: PROMIS-PI < 64 (lesser PI) and PROMIS-PI ≥ 64 (greater PI). PROs included PROMIS physical function, PROMIS anxiety (PROMIS-A), PROMIS sleep disturbance (PROMIS-SD), PROMIS-PI, Patient Health Questionnaire-9, Visual Analog Scale (VAS) back, VAS leg, and Oswestry Disability Index (ODI) and were collected at preoperative and postoperative time points. Demographics, perioperative characteristics, PROs, and Minimum Clinically Important Difference (MCID) were compared among groups through non-parametric inferential statistics. One-hundred and seven patients were identified. Independent of preoperative PI, patients reported significant postoperative improvement in PROMIS physical function, PROMIS-A, PROMIS-PI, VAS back, VAS leg, and ODI. The greater PI cohort reported significant postoperative improvement in Patient Health Questionnaire-9 and PROMIS-SD. The lesser PI cohort reported superior preoperative PROs in all domains. Postoperatively, the lesser PI cohort reported superior 6-week PROMIS-A and PROMIS-SD. MCID achievement rates were higher in the greater PI cohort for PROMIS-PI, VAS back, VAS leg, and ODI. Patients with lower preoperative PI reported superior postoperative anxiety and sleep disturbance. Patients with greater preoperative PI had higher MCID achievement rates in PI, pain, and disability. Patients with greater preoperative PI undergoing lumbar decompression may demonstrate higher rates of clinically tangible improvement. [ABSTRACT FROM AUTHOR]

To compare patient-reported outcomes (PROMs), postoperative patient-reported satisfaction, and minimum clinically important difference (MCID) achievement after minimally invasive surgery lumbar decompression (MIS-LD) in patients stratified by their preoperative 12-Item Short-Form Mental Component Score (SF-12 MCS). Patients who underwent single-level/multilevel MIS-LD were included. PROMs were administered preoperatively and 6 weeks/12 weeks/6 months/1 year postoperatively. Patients were grouped by preoperative SF-12 MCS. Demographic/perioperative characteristics were compared among groups using a χ2 and Student t test for categorical and continuous variables, respectively. Mean PROM and postoperative satisfaction scores were compared using an unpaired Student t test. PROM improvement within cohorts was assessed with paired-samples t test. MCID achievement rates were compared using χ2 analysis. A total of 297 patients were included: 111 patients in SF-12 MCS <48.9 and 186 patients in the SF-12 MCS ≥48.9 cohort. Cohorts showed mean postoperative differences for visual analog scale (VAS) back score at 12 weeks, VAS leg score at 6 weeks/12 weeks, Oswestry Disability Index (ODI) at 6 weeks/12 weeks, SF-12 MCS at all postoperative time points, and 12-Item Short-Form Physical Component Score at 6 weeks/12 weeks (P < 0.022, all). Of patients in the SF-12 MCS <48.9 cohort, more achieved MCID for SF-12 MCS at all postoperative time points and ODI at 1 year (P < 0.023, all). More patients in the SF-12 MCS ≥48.9 cohort achieved MCID for VAS leg score at 12 weeks and 12-Item Short-Form Physical Component Score at 6 weeks (P < 0.038). Patients in the SF-12 MCS <48.9 cohort showed inferior postoperative satisfaction for VAS leg score at 6 weeks/12 weeks/1 year, VAS back score at 12 weeks, and ODI at all postoperative time points. Patients with inferior mental health preoperatively showed worse mean short-term postoperative clinical outcome for leg/back pain, physical function and disability, short-term and long-term postoperative satisfaction for leg pain and disability, and long-term satisfaction for sleeping/lifting/walking/standing/sex/travel. [ABSTRACT FROM AUTHOR]