Do Six-Week Postoperative Patient-Reported Outcomes Predict Long-Term Clinical Outcomes Following Lumbar Decompression?

• Published in: World neurosurgery Vol. 185; pp. e900 - e906
• Main Authors: Wolf, Jacob C., Kaul, Aayush, Anwar, Fatima N., Roca, Andrea M., Khosla, Ishan, Loya, Alexandra C., Medakkar, Srinath S., Federico, Vincent P., Sayari, Arash J., Lopez, Gregory D., Singh, Kern
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2024
• Subjects: Adult; Aged; Decompression, Surgical - methods; Disability Evaluation; Female; Humans; Long-term; Lumbar decompression; Lumbar Vertebrae - surgery; Male; Middle Aged; Pain Measurement; Patient Reported Outcome Measures; Patient-reported outcomes; Predictors; Prognosis; Retrospective Studies; Treatment Outcome; Lumbar decompression; ODI; PROMIS-PF; VAS-B; LD; Long-term; VAS; Patient-reported outcomes; PHQ-9; PRO; VAS-L; Predictors
• ISSN: 1878-8750; 1878-8769; 1878-8769
• DOI: 10.1016/j.wneu.2024.02.149

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.