Effect of baseline veterans RAND-12 physical composite score on postoperative patient-reported outcome measures following lateral lumbar interbody fusion

• Published in: Acta neurochirurgica Vol. 165; no. 11; pp. 3531 - 3537
• Main Authors: Oyetayo, Omolabake O., Nie, James W., Hartman, Timothy J., MacGregor, Keith R., Zheng, Eileen, Anwar, Fatima N., Roca, Andrea M., Federico, Vincent P., Massel, Dustin H., Lopez, Gregory D., Sayari, Arash J., Singh, Kern
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01.11.2023; Springer Nature B.V
• Subjects: Clinical outcomes; Interventional Radiology; Medicine; Medicine & Public Health; Mental health; Minimally Invasive Surgery; Neurology; Neuroradiology; Neurosurgery; Original Article; Pain; Patients; Spine - Other; Surgical Orthopedics; Veterans RAND-12; Lateral lumbar interbody fusion; Patient-reported outcome measures; Physical function
• ISSN: 0942-0940; 0001-6268; 0942-0940
• DOI: 10.1007/s00701-023-05763-8

Purpose To determine the prognostic value of preoperative Veterans RAND-12 (VR-12) Physical Composite Score (PCS) scores on postoperative clinical outcomes in patients undergoing lateral lumbar interbody fusion (LLIF). Methods LLIF patients were separated into 2 cohorts based on preoperative VR-12 PCS scores: VR-12 PCS < 30 (lesser physical function) and VR-12 PCS ≥ 30 (greater physical function). Patient-reported outcome measures (PROMs) of VR-12 PCS, VR-12 Mental Composite Score (MCS), Short Form-12 (SF-12) PCS, SF-12 MCS, Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF), Patient Health Questionnaire-9 (PHQ-9), Visual Analog Scale (VAS) Back Pain (VAS-BP), VAS Leg Pain (VAS-LP), and Oswestry Disability Index (ODI) were collected at preoperative and up to 2-year postoperative time points. Mean postoperative follow-up time was 16.69 ± 8.53 months. Minimum clinically important difference (MCID) achievement was determined by comparing ∆PROM to previously established thresholds. Results Seventy-eight patients were included, with 38 patients with lesser preoperative physical function scores. Patients with lesser physical function reported significantly inferior preoperative PROM scores in all domains, except for SF-12 MCS and VAS-LP. At the 6-week postoperative time point, patients with lesser physical function reported significantly inferior VR-12 PCS, VR-12 MCS, SF-12 PCS, PROMIS-PF, and PHQ-9. At the final postoperative time point, patients with lesser physical function reported significantly inferior VR-12 PCS, VR-12 MCS, PROMIS-PF, PHQ-9, and ODI. Magnitude of 6-week postoperative improvement was significantly higher in the lesser physical function cohort for VR-12 PCS. Conclusion Patients undergoing LLIF with worse baseline VR-12 PCS scores reported inferior postoperative physical function, mental health, and disability outcomes. At the final postoperative follow-up, magnitude of postoperative improvement and MCID achievement did not significantly differ. Baseline VR-12 PCS scores may indicate inferior postoperative clinical outcomes in physical function, mental health, and disability in patients undergoing LLIF; however, baseline VR-12 PCS does not limit the magnitude of postoperative improvement.