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To determine the effect of age within the younger population seen at ambulatory surgical centers on patient-reported outcome measures (PROMs) after cervical spine surgery. Patients of age <65 years undergoing single-level anterior cervical discectomy and fusion (ACDF) or cervical disc replacement (CDR) were included. Patients were divided by mean age of initial population (46 years). PROMs included Patient-reported Outcome Measurement Information System Physical Function (PROMIS-PF), 12-Item Short-Form Physical Component Survey (SF-12 PCS), Visual Analog Scale (VAS) neck, VAS arm, Neck Disability Index (NDI) collected preoperatively and at postoperative time points up to 2 years. 138 patients were included, with 66 patients <46 years. Both cohorts demonstrated improvement from preoperative baseline with regard to all studied PROMs at multiple time points postoperatively (p ≤ 0.042, all). Between groups, the older cohort demonstrated greater mean PROMIS-PF scores preoperatively and at 6 weeks (p ≤ 0.011, both), while VAS arm scores were lower in the older group at 1 year (p = 0.002), and NDI scores were lower in the older group at 6 weeks and 1 year (p < 0.027, both). Minimal Clinically Important Difference (MCID) achievement rates were greater in the younger group in PROMIS PF at 2 years (p = 0.002), and in the older group in VAS arm score at 1 year (p = 0.007). Both cohorts showed significant improvement at multiple postoperative time points for all PROMs. Between groups, the older group reported more favorable physical function, VAS arm, and NDI scores at several time points. However, MCID achievement rates only significantly differed in two PROMs at singular time points. Difference in age in patients <65 years likely does not significantly affect long-term outcomes after cervical spine surgery. [ABSTRACT FROM AUTHOR]

To compare perioperative characteristics and patient-reported outcome measures (PROMs) in workers' compensation (WC) patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in either the inpatient/outpatient setting. Patients with WC undergoing 1-level MIS-TLIF were included. Patients were separated into inpatient/outpatient groups and demographically propensity score matched. PROMs included visual analog scale (VAS) back/VAS leg/Oswestry Disability Index (ODI)/12-item Short Form Physical Composite Score (SF-12 PCS)/Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF) preoperatively and 6 weeks, 12 weeks, 6 months, and 1 year postoperatively. Results were compared preoperatively and postoperatively and between cohorts. Minimum clinically important difference (MCID) achievement was determined through comparison with values established in the literature. A total of 216 patients were included (184 inpatient). The inpatient cohort (IC) showed worse perioperative outcomes in multiple measures (P < 0.034; all). The IC improved in all PROMs (P < 0.038; all), besides ODI at 6 weeks, SF-12 PCS at 6 weeks/6 months/1 year, and PROMIS-PF at 6 weeks. The outpatient cohort (OC) improved in VAS back at all time points and VAS leg at 6 months (P < 0.033; all). Between cohorts, the OC showed better scores with VAS leg/ODI/SF-12 PCS/PROMIS-PF at multiple time points (P < 0.031; all). Most of the IC achieved MCID, aside from ODI, whereas the OC achieved MCID in SF-12 PCS. MCID achievement between cohorts was higher in the IC at PROMIS-PF at 1 year and VAS back overall (P < 0.034; all). Despite more comorbidities and worse perioperative measures, the IC showed improved PROMs from preoperative to ≥1 follow-up visit, whereas the OC had improvement with only VAS back and leg. The IC showed multiple MCID achievements, whereas the OC showed MCID in only SF-12 PCS. These findings may help guide a surgeon's decision making between inpatient/outpatient lumbar surgery in the WC population. [ABSTRACT FROM AUTHOR]

To compare patient-reported outcome measure (PROM) scores and minimum clinically important difference (MCID) achievement rates among patients undergoing single-level anterior cervical discectomy and fusion (ACDF) in patients with varying severity of preoperative visual analog scale (VAS) neck score. Patients with ACDF were grouped: severity of preoperative VAS neck score ≤8 or >8. Demographic/perioperative variables and PROMs (Patient-Reported Outcomes Measurement Information System Physical Function [PROMIS PF] score, 12-Item Short Form [SF-12] Mental Component Score [MCS], VAS neck/arm score, and Neck Disability Index [NDI]) were collected preoperatively/postoperatively. MCID attainment comparison by grouping was evaluated using χ2 analysis. A total of 137 patients were included (103 VAS neck preoperative score ≤8; 34 VAS neck preoperative score >8). The VAS neck preoperative score ≤8 cohort did not improve: 6 weeks PROMIS-PF score, 6 weeks SF-12 Physical Component Score [PCS], 12 weeks/1 year/2 years SF-12 MCS, 2 years VAS neck score, and 1 years/2 years VAS arm score (P ≤ 0.015, all). VAS neck preoperative score >8 did not improve: 6 weeks/12 weeks/2 years PROMIS-PF score, all time points SF-12 PCS, 6 weeks/12 weeks/1 year/2 years SF-12 MCS, and 2 years VAS arm score (P ≤ 0.013, all). VAS neck preoperative score >8 had inferior PROMIS-PF scores all time points except 1 year (P ≤ 0.036, all), lower SF-12 PCS 6 weeks/6 months (P ≤ 0.043, both), inferior SF-12 MCS at preoperative to 6 months (P ≤ 006, all), higher VAS neck score from preoperative to 6 months (P ≤ 0.018), higher VAS arm score preoperative/12 weeks/6 months (P ≤ 0.020, all), and higher NDI at preoperative/12 weeks/6 months (P ≤ 0.030, all). MCID attainment rates for VAS neck preoperative score >8 were greater for NDI 2 years (P = 0.040), lower for PROMIS-PF score 2 years, and overall (P = 0.018), lower for SF-12 MCS 12 weeks (P = 0.046), lower for VAS neck score 12 weeks to 1 year and overall (P ≤ 0.032, all), and lower for VAS arm score 6 weeks/1 year (P ≤ 0.030, both). Patients with single-level ACDF presenting with greater baseline neck pain showed poorer physical function/pain/disability/mental health at preoperative/intermediate postoperative time points, but had comparable long-term PROMs by 2 years. MCID attainment was lower among patients with greater preoperative neck pain; MCID among the VAS neck score >8 cohort were only significantly inferior for neck pain. [ABSTRACT FROM AUTHOR]

To assess differences in postoperative patient-reported outcome measures (PROMs) and minimal clinically important difference (MCID) attainment following single-level anterior cervical discectomy and fusion based on predominant preoperative pain symptom. Patients undergoing primary, single-level anterior cervical discectomy and fusion were identified. PROMs included visual analog scale (VAS) arm and neck, 12-item short-form physical component summary (SF-12 PCS), Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF), and Neck Disability Index, collected preoperatively and postoperatively. Patients were placed in preoperative predominant arm pain (pAP) and preoperative predominant neck pain groups. χ2 test compared demographic and perioperative characteristics, and MCID attainment rates. Student t test evaluated change from preoperative to postoperative PROM values and compared PROMs between groups. There were 110 patients assessed (52 neck pain, 58 arm pain). Patients with preoperative predominant neck pain improved significantly from preoperative to postoperative at 12 weeks to 1 year for PROMIS-PF, 6 months and 1 year for SF-12 PCS, 6 weeks to 1 year for VAS neck, 6 weeks to 6 months for VAS arm, and 6 weeks to 2 years for Neck Disability Index (all P ≤ 0.035). Patients with pAP improved significantly from preoperative to all postoperative time points for PROMIS-PF, 6 months to 2 years for SF-12 PCS, 6 weeks to 1 year for VAS neck, 6 weeks to 1 year for VAS arm, and 6 weeks to 6 months for Neck Disability Index (all P ≤ 0.040). Mean PROMIS-PF was higher at 6 weeks, preoperative VAS neck was lower, and preoperative VAS arm was higher for pAP patients (all P ≤ 0.013). MCID attainment was significantly higher in pAP patients for PROMIS-PF from 6 weeks to 6 months, SF-12 PCS 6 weeks, and VAS arm 12 weeks. Predominant pain symptom demonstrated little effect on perioperative characteristics and postoperative PROMs. Anterior cervical discectomy and fusion candidates will likely experience similar clinically meaningful postoperative improvements in physical function, disability, and pain. [ABSTRACT FROM AUTHOR]

To determine preoperative 12-Item Short Form Health Survey (SF-12) Mental Component Summary (MCS) influence on minimally important clinical difference (MCID) and patient-reported outcome measures in patients with isthmic spondylolisthesis receiving minimally invasive transforaminal lumbar interbody fusion. Patients with isthmic spondylolisthesis undergoing primary, single-level minimally invasive transforaminal lumbar interbody fusion at L5-S1 were retrospectively identified and divided into preoperative SF-12 MCS <50 and SF-12 MCS ≥50 groups. Visual analog scale (VAS) back/leg, Oswestry Disability Index (ODI), SF-12 Physical Composite Score (PCS), and Patient-Reported Outcome Measurement Information System physical function (PROMIS-PF) were assessed. Improvements from preoperative score were analyzed via paired samples t test. Patient-reported outcome measures and MCID attainment between groups were evaluated using linear regression and χ2, respectively. SF-12 MCS <50 and SF-12 MCS ≥50 groups included 35 and 26 patients, respectively. SF-12 MCS < 50 group had inferior scores for all VAS back time points except 6 weeks, all VAS leg time points except 6 weeks/1 year, all ODI time points, SF-12 PCS at 6 months/2 years, and PROMIS-PF at preoperative/6 months (all P ≤ 0.049). SF-12 MCS <50 group improved for VAS back/leg to 1 year, ODI and SF-12 PCS from 12 weeks to 1 year, and PROMIS-PF at 1 year only (all P ≤ 0.047). SF-12 MCS ≥50 group improved for VAS back from 12 weeks to 1 year, SF-12 PCS 6 months to 2 years, and VAS leg, ODI, and PROMIS-PF 12 weeks to 2 years (all P ≤ 0.018). MCID attainment differed for ODI at 6 weeks and PROMIS-PF at 12 weeks only (both P ≤ 0.035). Patients with SF-12 MCS <50 demonstrated fewer long-term improvements from preoperative to 2 years and inferior patient-reported outcome measures at most time points for pain and disability following minimally invasive transforaminal lumbar interbody fusion. MCID attainment largely did not differ by preoperative mental functioning. [ABSTRACT FROM AUTHOR]

We sought to assess differences in patient-reported outcome measures (PROMs) between patients who do and do not follow up for 2 years after lumbar fusion. Primary, elective, single-level anterior lumbar interbody fusion, lateral lumbar interbody fusion, or transforaminal lumbar interbody fusion procedures were identified. Patients were grouped by 2-year PROM follow-up completion. Mean and delta PROM scores for visual analog scale (VAS) back and leg, Oswestry Disability Index (ODI), short-form (SF)-12 Physical Composite Score (PCS), and Mental Composite Score (MCS) were computed for both groups preoperatively and postoperatively. Minimum clinically important difference (MCID) achievement was determined for PROM scores using established threshold values. Linear and logistic regression assessed mean and ΔPROM scores as predictors of 2-year follow-up completion and compared MCID achievement between groups, respectively. We included 316 lumbar fusion patients. PROM scores were more favorable for complete follow-up patients for 6-month VAS back (P = 0.003), 6-month and 1-year ODI (P ≤ 0.027, both), and 6-week and 6-month SF-12 PCS (P ≤ 0.015, both). Six-month VAS back (P = 0.007); 6-month and 1-year ODI (P ≤ 0.028, both); 6-week, 6-month, and 1-year SF-12 PCS (P ≤ 0.041, all); and 6-week SF-12 MCS (P ≤ 0.028, both) significantly predicted 2-year follow-up. ΔPROMs significantly differed between groups at 1 year for ΔVAS leg (P = 0.029), ΔODI (P = 0.013), and ΔSF-12 MCS (P = 0.004). One-year ΔVAS leg (P = 0.035), ΔODI (P = 0.011), and ΔSF-12 MCS (P = 0.003) significantly predicted follow-up. MCID achievement for ΔPROMs significantly differed between groups for 6-week VAS leg (P = 0.035), overall ODI (P = 0.034), and SF-12 PCS from 12 weeks through 1 year (P ≤ 0.011, all) and overall (P < 0.001). Patients with full follow-up demonstrated significantly more favorable outcome scores and improvement in pain, disability, and physical function at several postoperative time points. [ABSTRACT FROM AUTHOR]