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Impact of Dominant Symptom on 12-Month Patient-Reported Outcomes for Patients Undergoing Lumbar Spine Surgery.

Publication ,  Journal Article
Devin, CJ; Asher, AL; Archer, KR; Goyal, A; Khan, I; Kerezoudis, P; Alvi, MA; Pennings, JS; Karacay, B; Shaffrey, CI; Bisson, EF; Knightly, JJ ...
Published in: Neurosurgery
October 15, 2020

BACKGROUND: The impact of symptom characteristics on outcomes of spine surgery remains elusive. OBJECTIVE: To determine the impact of symptom location, severity, and duration on outcomes following lumbar spine surgery. METHODS: We queried the Quality Outcomes Database (QOD) for patients undergoing elective lumbar spine surgery for lumbar degenerative spine disease. Multivariable regression was utilized to determine the impact of preoperative symptom characteristics (location, severity, and duration) on improvement in disability, quality of life, return to work, and patient satisfaction at 1 yr. Relative predictor importance was determined using an importance metric defined as Wald χ2 penalized by degrees of freedom. RESULTS: A total of 22 022 subjects were analyzed. On adjusted analysis, we found patients with predominant leg pain were more likely to be satisfied (P < .0001), achieve minimum clinically important difference (MCID) in Oswestry Disability Index (ODI) (P = .002), and return to work (P = .03) at 1 yr following surgery without significant difference in Euro-QoL-5D (EQ-5D) (P = .09) [ref = predominant back pain]. Patients with equal leg and back pain were more likely to be satisfied (P < .0001), but showed no significant difference in achieving MCID (P = .22) or return to work (P = .07). Baseline numeric rating scale-leg pain and symptom duration were most important predictors of achieving MCID and change in EQ-5D. Predominant symptom was not found to be an important determinant of return to work. Worker's compensation was found to be most important determinant of satisfaction and return to work. CONCLUSION: Predominant symptom location is a significant determinant of functional outcomes following spine surgery. However, pain severity and duration have higher predictive importance. Return to work is more dependent on sociodemographic features as compared to symptom characteristics.

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Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

October 15, 2020

Volume

87

Issue

5

Start / End Page

1037 / 1045

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Symptom Assessment
  • Quality of Life
  • Patient Satisfaction
  • Patient Reported Outcome Measures
  • Neurosurgical Procedures
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Lumbar Vertebrae
 

Citation

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Devin, C. J., Asher, A. L., Archer, K. R., Goyal, A., Khan, I., Kerezoudis, P., … Bydon, M. (2020). Impact of Dominant Symptom on 12-Month Patient-Reported Outcomes for Patients Undergoing Lumbar Spine Surgery. Neurosurgery, 87(5), 1037–1045. https://doi.org/10.1093/neuros/nyaa240
Devin, Clinton J., Anthony L. Asher, Kristin R. Archer, Anshit Goyal, Inamullah Khan, Panagiotis Kerezoudis, Mohammed Ali Alvi, et al. “Impact of Dominant Symptom on 12-Month Patient-Reported Outcomes for Patients Undergoing Lumbar Spine Surgery.Neurosurgery 87, no. 5 (October 15, 2020): 1037–45. https://doi.org/10.1093/neuros/nyaa240.
Devin CJ, Asher AL, Archer KR, Goyal A, Khan I, Kerezoudis P, et al. Impact of Dominant Symptom on 12-Month Patient-Reported Outcomes for Patients Undergoing Lumbar Spine Surgery. Neurosurgery. 2020 Oct 15;87(5):1037–45.
Devin, Clinton J., et al. “Impact of Dominant Symptom on 12-Month Patient-Reported Outcomes for Patients Undergoing Lumbar Spine Surgery.Neurosurgery, vol. 87, no. 5, Oct. 2020, pp. 1037–45. Pubmed, doi:10.1093/neuros/nyaa240.
Devin CJ, Asher AL, Archer KR, Goyal A, Khan I, Kerezoudis P, Alvi MA, Pennings JS, Karacay B, Shaffrey CI, Bisson EF, Knightly JJ, Mummaneni PV, Foley KT, Bydon M. Impact of Dominant Symptom on 12-Month Patient-Reported Outcomes for Patients Undergoing Lumbar Spine Surgery. Neurosurgery. 2020 Oct 15;87(5):1037–1045.
Journal cover image

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

October 15, 2020

Volume

87

Issue

5

Start / End Page

1037 / 1045

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Symptom Assessment
  • Quality of Life
  • Patient Satisfaction
  • Patient Reported Outcome Measures
  • Neurosurgical Procedures
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Lumbar Vertebrae