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Although the Veterans RAND 12-item Physical Component Survey (VR-12 PCS) has been broadly used to evaluate patient-reported outcome measures (PROMs) in spine surgery, its feasibility for use in patients undergoing minimally invasive lumbar discectomy (MIS LD) has not been well studied. This study aimed to assess the feasibility of VR-12 PCS for use up to 2 years postoperatively for MIS LD by correlation with PROMs for physical function. Patients undergoing primary single-level MIS LD procedures were reviewed retrospectively. Results on the VR-12 PCS, 12-Item Short Form (SF-12) PCS, and Patient-Reported Outcomes Measurement Information System (PROMIS PF) were recorded preoperatively and up to 2 years postoperatively. Improvements in postoperative PROMs were calculated and assessed for significant differences from baseline values. Correlation significance and strength were evaluated between VR-12 PCS and SF-12 PCS or PROMIS PF. Scatterplots were constructed to demonstrate relationships of VR-12 PCS with SF-12 PCS and PROMIS PF at each time point. Our cohort comprised 402 patients. Patients improved significantly from preoperative baseline for all 3 PROMs at all postoperative time points. Both Pearson's correlation and time-independent partial correlation revealed statistically significant strong correlations of VR-12 PCS with SF-12 PCS and PROMIS PF through 2-years. Physical function scores for VR-12, SF-12, and PROMIS PF all demonstrated significant improvements following MIS LD. Strongly statistically significant correlations of VR-12 PCS with SF-12 PCS and PROMIS PF from preoperative measures through 2 years demonstrate the feasibility of VR-12 for assessing patient-reported physical function in MIS LD patients. [ABSTRACT FROM AUTHOR]

Diabetes mellitus (DM) has been identified as a risk factor for poorer outcomes following anterior cervical discectomy and fusion (ACDF). This study aims to evaluate the impact DM has on achievement of MCID (minimum clinically important difference) following ACDF. A surgical database was reviewed for patients who underwent primary, single-level ACDF procedures with posterior instrumentation. Visual analog scales (VAS) Arm and Neck, Neck Disability Index (NDI), and Patient-Reported Outcomes Measurement Information System (PROMIS) and 12-item Short Form (SF-12) scores for physical function (PF) were recorded. MCID achievement was calculated using pre-established values from the literature. Intergroup differences in demographic, perioperative characteristics, mean outcome scores and rates of MCID achievement were calculated. There were 43 patients with diabetes and 320 patients without diabetes. DM status was significantly associated with age, ethnicity, hypertension, American Society of Anesthesiologists physical classification score, Charlson Comorbidity Index, and insurance type (all P ≤ 0.041). Postoperative length of stay was significantly greater for the DM group (P = 0.011). Mean VAS Arm and NDI differed at 6 months (P ≤ 0.049, both) and PROMIS-PF differed from 6 weeks through 6 months (P ≤ 0.039, all). Patients without diabetes significantly improved in all PROMs by 1 year postoperatively (P < 0.01, all). Patients with diabetes significantly improved in VAS Neck and Arm, SF-12 physical component score, and PROMIS-PF by 1 year (all P ≤ 0.013) but NDI significantly improved only at 12 weeks (P = 0.038). Intergroup differences for MCID achievement were demonstrated at 6 months for NDI and SF-12 physical component score (P ≤ 0.008). Although moderate intergroup differences in MCID achievement were demonstrated, the results of this study suggest that patients may realize similar benefits of ACDF surgery regardless of DM status. [ABSTRACT FROM AUTHOR]

To determine the association between patient-reported depressive symptoms and patient satisfaction following minimally invasive lumbar decompression. Primary, single-level/multilevel minimally invasive lumbar decompression was identified. Patient-reported outcome measures (PROMs) collected preoperatively/postoperatively included visual analog scale back/leg, Oswestry Disability Index, 9-Item Patient Health Questionnaire (PHQ-9), and 12-Item Short Form Mental Composite Score (SF-12 MCS). Patients rated current satisfaction level (0–10) with back/leg pain and disability. A paired Student's t-test compared each postoperative PROM score to its preoperative baseline. At each timepoint, patients were categorized by PHQ-9 and SF-12 MCS scores. One-way analysis of variance compared patient satisfaction with back/leg pain and disability among PHQ-9 subgroups. The Student's t-test for independent samples compared patient satisfaction between SF-12 MCS subgroups. Analysis of covariance (ANCOVA) assessed differences in satisfaction between depression subgroups while controlling for preoperative/postoperative values in corresponding PROMs. 193 patients were included. All PROMs demonstrated significant postoperative improvement from 6-weeks through 2-years (P < 0.001, all), except PHQ at 9 2-years (P = 0.874). Mean satisfaction scores ranged from 6.9–7.9 (back pain), 7.3–8.0 (leg pain), and 7.6–8.0 (disability). Satisfaction with back/leg pain and disability significantly differed among PHQ-9 subgroups at all postoperative timepoints (P < 0.001, all). Accounting for baseline and current pain/disability values, ANCOVA revealed differences between PHQ-9 subgroups only in satisfaction with back pain at 2 years (P < 0.001), leg pain at 12 weeks/1 year/2 years (P ≤ 0.047, all), and disability at 6 months/2 years (P ≤ 0.049, both). Satisfaction differed between SF-12 MCS subgroups at all timepoints (P ≤ 0.047), except back pain 6 months (P = 0.263). Accounting for baseline and postoperative pain/disability, ANCOVA revealed differences in satisfaction between SF-12 MCS groups only for back/leg pain at 2 years (P ≤ 0.001, both). Independent effect of depression at long-term follow-up was significant. This highlights the importance of understanding the interaction between physical and mental health outcomes to optimize patients' perceptions of surgical outcomes. [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]