Association of Preoperative PROMIS Scores With Short-term Postoperative Improvements in Physical Function After Minimally Invasive Transforaminal Lumbar Interbody Fusion

Overview

Journal Neurospine

Date 2020 Jul 4

PMID 32615700

Citations 2

Authors

Nathaniel W Jenkins

James M Parrish

Thomas S Brundage

Nadia M Hrynewycz

Kern Singh

Affiliations

Soon will be listed here.

Abstract

Objective: This study examines the associations between preoperative Patient-Reported Outcomes Measurement Information System (PROMIS) physical function (PF) score, measured by PROMIS-PF and the change between pre- and postoperative PROMIS-PF scores.

Methods: A prospectively maintained surgical registry was retrospectively reviewed for spine surgeries between May 2015-June 2019. Inclusion criteria were primary, single-level minimally invasive transforaminal lumbar interbody fusions. Revisions, multilevel procedures, and patients missing preoperative surveys were excluded. Patients were grouped by preoperative PROMIS-PF scores of ≥ 35 and < 35, with higher scores indicating greater PF. A chi-squared and Student t-test were used to analyze categorical and continuous variables respectively. Linear regression evaluated the relationship of PROMIS-PF score improvement.

Results: Of the 180 subjects, 84 were in the PROMIS-PF < 35 group which had more obese patients (p < 0.001) and more males (p = 0.001). Length of stay was greater for the PROMIS-PF < 35 group (36.2 hours vs. 28.7 hours, p = 0.014). PROMIS-PF and Oswestry Disability Index scores were significantly different between subgroups at all timepoints. PROMIS-PF < 35 cohort had larger postoperative PROMIS-PF improvements at 6 weeks (p = 0.008) and 12 weeks (p = 0.003). Linear regression demonstrated a negative association between preoperative PROMIS-PF scores and improvement at 6 weeks, 12 weeks, 6 months, and 2 years (p < 0.001). PROMIS-PF < 35 demonstrated significantly lower rate of achieving minimum clinically important difference at 6 months, otherwise no difference observed throughout the 2-year follow-up.

Conclusion: Up to 6 months postoperatively, lower preoperative PROMIS-PF scores were associated with larger PROMIS-PF improvements. Understanding the relationship preoperative PROMIS-PF scores have with postoperative improvement may enable better patient counseling.

Citing Articles

Pearls and pitfalls of PROMIS clinically significant outcomes in orthopaedic surgery.

Gilat R, Mitchnik I, Patel S, Dubin J, Agar G, Tamir E Arch Orthop Trauma Surg. 2023; 143(11):6617-6629.

PMID: 37436494 DOI: 10.1007/s00402-023-04983-y.

Association Between Patient Reported Outcomes Measurement Information System Physical Function With Postoperative Pain, Narcotics Consumption, and Patient-Reported Outcome Measures Following Lumbar Microdiscectomy.

Bovonratwet P, Vaishnav A, Mok J, Urakawa H, Dupont M, Melissaridou D Global Spine J. 2022; 14(1):225-234.

PMID: 35623628 PMC: 10676173. DOI: 10.1177/21925682221103497.

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