Objective To assess change in Patient-Reported Outcome Measures (PROM) as predictors for revision lumbar decompression (LD).
Methods Patients who underwent primary, single or multilevel LD were retrospectively reviewed. Patients were categorized according to whether or not they underwent revision LD within 2 years of the primary procedure. Visual analogue scale (VAS), Oswestry Disability Index (ODI), 12-item Short Form Health Survey and 12-item Veterans RAND physical component score (SF-12 PCS and VR-12 PCS), and Patient-Reported Outcome Measurement Information System physical function (PROMIS-PF) were recorded. Delta PROM scores were evaluated for differences between groups and as a risk factor for a revision LD.
Results The study included 135 patients, 91 undergoing a primary procedure only and 44 undergoing a primary and revision procedure. Matched patients did not demonstrate any significant differences in demographics or perioperative characteristics. Patients who underwent a revision had a mean time to revision of 7.4 ± 5.7 months. Primary cohort significantly improved for all PROMs (all p < 0.05), while the primary plus revision cohort significantly improved for VAS back, ODI, and PROMIS-PF (all p < 0.05). However, cohorts differed in VAS back and PROMIS-PF (p < 0.05). Delta PROMs were not a significant risk factor for revision except at 6 months for PROMIS-PF (p = 0.024).
Conclusion LD has been associated with reliable outcomes, but early identification of patients at risk for revision is critical. This study suggests that tools such as PROMIS-PF may serve a role in predicting who is at risk and the 6-month follow-up period may be valuable for counseling patients who are not experiencing improvement.
Citations
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Use of the Patient-Reported Outcomes Measurement Information System (PROMIS) Outcome Measures in Lumbar Decompression Surgery: A Systematic Review Harneet K Cheema, Manraj S Cheema, James Gomes Cureus.2026;[Epub] CrossRef
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Arash J. Sayari, Garrett K. Harada, Philip K. Louie, Michael H. McCarthy, Michael T. Nolte, Gary M. Mallow, Zakariah Siyaji, Niccole Germscheid, Jason P.Y. Cheung, Marko H. Neva, Mohammad El-Sharkawi, Marcelo Valacco, Daniel M. Sciubba, Norman B. Chutkan, Howard S. An, Dino Samartzis
Neurospine 2020;17(2):313-330. Published online June 30, 2020
Objective To determine if personal health of spine surgeons worldwide influences perceptions, healthcare delivery, and decision-making during the coronavirus disease 2019 (COVID-19) pandemic.
Methods A cross-sectional study was performed by distributing a multidimensional survey to spine surgeons worldwide. Questions addressed demographics, impacts and perceptions of COVID-19, and the presence of surgeon comorbidities, which included cancer, cardiac disease, diabetes, obesity, hypertension, respiratory illness, renal disease, and current tobacco use. Multivariate analysis was performed to identify specific comorbidities that influenced various impact measures.
Results Across 7 global regions, 36.8% out of 902 respondents reported a comorbidity, of which hypertension (21.9%) and obesity (15.6%) were the most common. Multivariate analysis noted tobacco users were more likely to continue performing elective surgery during the pandemic (odds ratio [OR], 2.62; 95% confidence interval [CI], 1.46–4.72; p = 0.001) and were less likely to utilize telecommunication (OR, 0.51; 95% CI, 0.31–0.86; p = 0.011), whereas those with hypertension were less likely to warn their patients should the surgeon become infected with COVID-19 (OR, 0.57; 95% CI, 0.37–0.91; p = 0.017). Clinicians with multiple comorbidities were more likely to cite personal health as a current stressor (OR, 1.32; 95% CI, 1.07–1.63; p = 0.009) and perceived their hospital’s management unfavorably (OR, 0.74; 95% CI, 0.60–0.91; p = 0.005).
Conclusion This is the first study to have mapped global variations of personal health of spine surgeons, key in the development for future wellness and patient management initiatives. This study underscored that spine surgeons worldwide are not immune to comorbidities, and their personal health influences various perceptions, healthcare delivery, and decision-making during the COVID-19 pandemic.
Citations
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The Impact of COVID-19 Pandemic on Spine Surgeons Worldwide: A One Year Prospective Comparative Study Juan N. Barajas, Alexander L. Hornung, Timothy Kuzel, Gary M. Mallow, Grant J. Park, Samuel S. Rudisill, Philip K. Louie, Garrett K. Harada, Michael H. McCarthy, Niccole Germscheid, Jason PY. Cheung, Marko H. Neva, Mohammad El-Sharkawi, Marcelo Valacco, D Global Spine Journal.2024; 14(3): 956. CrossRef
Trends in degenerative lumbar spinal surgery during the early COVID-19 pandemic in Republic of Korea: A national study utilizing the national health insurance database Woon Tak Yuh, Jinhee Kim, Mi-Sook Kim, Jun-Hoe Kim, Young Rak Kim, Sum Kim, Chun Kee Chung, Chang-Hyun Lee, Sung Bae Park, Kyoung-Tae Kim, John M. Rhee, Young San Ko, Chi Heon Kim, Kentaro Yamada PLOS ONE.2024; 19(6): e0305128. CrossRef
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