Discrepancy between global- and disease-specific outcome measures following lumbar spine surgery.

IF 2.9 2区 医学 Q2 CLINICAL NEUROLOGY
Journal of neurosurgery. Spine Pub Date : 2024-07-19 Print Date: 2024-11-01 DOI:10.3171/2024.4.SPINE24282
Avani S Vaishnav, Cole Kwas, Jung Kee Mok, Kasra Araghi, Nishtha Singh, Olivia Tuma, Maximilian Korsun, Chad Z Simon, Tomoyuki Asada, Eric Mai, Joshua Zhang, Myles Allen, Eric Kim, Annika Heuer, Sravisht Iyer, Sheeraz Qureshi
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Abstract

Objective: The aim of this study was to assess the correlation between patient-perceived changes in health and commonly utilized patient-reported outcome measures (PROMs) in lumbar spine surgery.

Methods: This was a retrospective review of prospectively collected data on consecutive patients who underwent lumbar microdiscectomy, lumbar decompression, or lumbar fusion at a single academic institution from 2017 to 2023. Correlation between the global rating of change (GRC) questionnaire, a 5-item Likert scale (much better, slightly better, about the same, slightly worse, and much worse), and PROMs (Oswestry Disability Index, visual analog scale for back and leg pain, 12-Item Short Form Health Survey Physical Component Summary and Mental Component Summary, and PROMIS physical function) was assessed using Spearman's rank correlation coefficients.

Results: A total of 1871 patients (397 microdiscectomies, 965 decompressions, and 509 fusions) were included. A majority of patients in each group rated their lumbar condition as much better at each postoperative time point compared with preoperatively and reported improved health status at each postoperative time point compared with the previous follow-up visit. Statistically significant but weak to moderate correlations were found between GRC and change in PROM scores from the preoperative time point. Correlation between GRC and change in PROM scores from the prior visit showed some statistically significant correlations, but the strengths ranged from very weak to weak.

Conclusions: A majority of patients undergoing lumbar microdiscectomy, decompression, or fusion endorsed notable improvements in health status in the early postoperative period and continued to improve at late follow-up. However, commonly used PROMs demonstrated very weak to moderate correlations with patient-perceived changes in overall lumbar spine-related health status as determined by GRC. Therefore, currently used PROMs may not be as sensitive at detecting these changes or may not be adequately reflecting changes in health conditions that are meaningful to patients undergoing lumbar spine surgery.

腰椎手术后的总体疗效与疾病特异性疗效之间存在差异。
研究目的本研究旨在评估腰椎手术中患者感知的健康变化与常用的患者报告结果指标(PROMs)之间的相关性:这是对2017年至2023年期间在一家学术机构接受腰椎显微切除术、腰椎减压术或腰椎融合术的连续患者的前瞻性收集数据进行的回顾性研究。使用斯皮尔曼秩相关系数评估了全球变化评分(GRC)问卷、5项Likert量表(好得多、稍好、差不多、稍差和差得多)与PROMs(Oswestry残疾指数、腰腿痛视觉模拟量表、12项简表健康调查身体成分摘要和精神成分摘要以及PROMIS身体功能)之间的相关性:共纳入了 1871 例患者(397 例显微椎间盘切除术、965 例减压术和 509 例融合术)。与术前相比,各组中大多数患者在术后各时间点都认为自己的腰椎状况大为改善,并称术后各时间点的健康状况比上次随访时有所改善。GRC 与 PROM 评分与术前时间点相比的变化之间存在有统计学意义的弱到中等程度的相关性。GRC与前次随访的PROM评分变化之间的相关性在统计学上有一定意义,但强度从非常弱到弱不等:结论:大多数接受腰椎显微椎间盘切除术、减压术或融合术的患者在术后早期的健康状况明显改善,并在后期随访中持续改善。然而,常用的 PROM 与 GRC 所确定的患者所感知的腰椎相关总体健康状况的变化之间的相关性很弱到中等。因此,目前使用的 PROM 在检测这些变化方面可能不够灵敏,或者不能充分反映对腰椎手术患者有意义的健康状况变化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of neurosurgery. Spine
Journal of neurosurgery. Spine 医学-临床神经学
CiteScore
5.10
自引率
10.70%
发文量
396
审稿时长
6 months
期刊介绍: Primarily publish original works in neurosurgery but also include studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology.
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