The influence of preoperative Veterans RAND-12 physical composite score in patients undergoing anterior lumbar interbody fusion [Retrospective Review]

• Published in: Journal of clinical neuroscience Vol. 123; pp. 36 - 40
• Main Authors: Anwar, Fatima N., Roca, Andrea M., Loya, Alexandra C., Medakkar, Srinath S., Nie, James W., Hartman, Timothy J., MacGregor, Keith R., Oyetayo, Omolabake O., Zheng, Eileen, Federico, Vincent P., Sayari, Arash J., Lopez, Gregory D., Singh, Kern
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.05.2024
• Subjects: Anterior lumbar interbody fusion; Outcomes; PROMs; Veterans RAND-12 Physical Composite Score; Veterans RAND-12 Physical Composite Score; Anterior lumbar interbody fusion; Outcomes; PROMs
• ISSN: 0967-5868; 1532-2653
• DOI: 10.1016/j.jocn.2024.03.017

•VR-12 PCS < 30 reported worse baseline mental and physical health and disability.•VR-12 PCS < 30 report greater postoperative improvements in mental/physical health.•At 6 weeks, lesser physical function correlates with worse physical health/PHQ-9.•At 6 weeks, VR-12 PCS < 30 saw better physical health/VR-12 MCS improvement.•VR-12 PCS < 30 saw better physical health/PHQ-9 improvement by final follow-up.•VR-12 PCS < 30 had higher MCID achievement rates for PHQ-9 and ODI. No study has evaluated the preoperative impact of Veterans RAND-12 Physical Composite Score (VR-12 PCS) on anterior lumbar interbody fusion (ALIF) patients. This study examines its influence on physical function, mental health, pain, and disability outcomes. Two cohorts of ALIF patients with preoperative VR-12 PCS scores were formed using a single-surgeon registry: VR-12 PCS < 30 and VR-12 PCS ≥ 30. Demographics, perioperative characteristics, and patient-reported outcome measures (PROMs) were collected. PROMs of VR-12 PCS/Mental Composite Score (MCS), Short Form-12 (SF-12) PCS/MCS, Patient-Reported Outcomes Measurement Information System-Physical Function (PROMIS-PF), Patient Health Questionnaire-9 (PHQ-9), Visual Analog Scale-Back/Leg Pain (VAS-BP/LP), and Oswestry Disability Index (ODI) were collected pre/postoperatively up to 2-years. Demographics, perioperative characteristics, and preoperative PROMs were compared. Intercohort postoperative 6-week/final PROMs and improvements were compared. Of 80 patients, there were 41 in the VR-12 PCS < 30 cohort. Besides VR-12 PCS, VR-12 PCS < 30 patients reported inferior preoperative VR-12 MCS/SF-12 PCS/PROMIS-PF/PHQ-9/ODI scores (p ≤ 0.003, all). At 6-weeks postoperatively, VR-12 PCS < 30 reported inferior VR-12 PCS/SF-12 PCS/PROMIS-PF/PHQ-9 (p ≤ 0.030, all). There was greater improvement up to 6-weeks postoperatively in VR-12 PCS < 30 for VR-12 PCS/MCS and SF-12 PCS (p ≤ 0.020, all). VR-12 PCS < 30 reported superior improvement by final follow-up in VR-12 PCS/SF-12 PCS/PHQ-9 (p ≤ 0.006, all). MCID achievement rates were higher in VR-12 PCS < 30 for PHQ-9 and ODI (p ≤ 0.013, both). VR-12 PCS < 30 patients reported inferior postoperative physical function, mental health, and disability, yet superior magnitude of improvement in physical function and mental health. Rates of clinically meaningful improvement for VR-12 PCS < 30 were greater in mental health and disability.