The Relationship Between Preoperative PROMIS Scores With Postoperative Improvements in Physical Function After Anterior Cervical Discectomy and Fusion
Autor: | James M. Parrish; Nathaniel W. Jenkins; Nadia M. Hrynewycz; Thomas S. Brundage; Kern Singh |
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Sprache: | Englisch; Koreanisch |
Veröffentlicht: |
2020 |
Quelle: | Directory of Open Access Journals: DOAJ Articles |
Online Zugang: |
http://www.e-neurospine.org/upload/pdf/ns-1938352-176.pdf https://doaj.org/toc/2586-6583 https://doaj.org/toc/2586-6591 2586-6583 2586-6591 doi:10.14245/ns.1938352.176 https://doaj.org/article/817ae4da49c94b8b9c5bf819d5cfedab https://doi.org/10.14245/ns.1938352.176 https://doaj.org/article/817ae4da49c94b8b9c5bf819d5cfedab |
Erfassungsnummer: | ftdoajarticles:oai:doaj.org/article:817ae4da49c94b8b9c5bf819d5cfedab |
Zusammenfassung
Objective Assess preoperative Patient-Reported Outcomes Measurement Information System (PROMIS) physical function (PF) scores and differences between preoperative and postoperative PROMIS-PF scores for patients undergoing anterior cervical discectomy and fusion (ACDF). Methods After Institutional Review Board approval, a prospectively maintained surgical registry was retrospectively reviewed for elective spine surgeries of nontraumatic, degenerative pathology between 2015–2018. Inclusion criteria were primary or revision, single-level ACDF procedures. Multilevel procedures and patients without preoperative surveys were excluded. A preoperative PROMIS score cutoff of 35 divided patients into PROMIS-PF score categories (e.g., ≥ 35.0, < 35.0). Categorical and continuous variables were evaluated with chi-square tests and t-tests. Linear regression analyzed PROMIS-PF score improvement. Results Eighty-six patients were selected, the high and low PROMIS-PF subgroups only differed in mean age (49.1 vs. 41.3, p = 0.002). Significant differences in PROMIS-PF scores were observed among high and low preoperative PROMIS-PF score subgroups at 6 weeks (p = 0.006), 12 weeks (p = 0.006), and 6 months (p = 0.014). Mean differences between preoperative and postoperative PROMIS-PF scores were significantly different between the high and low PROMIS-PF subgroups at 6 weeks (p = 0.041) and 1 year (p = 0.038). A significant negative association was observed between preoperative PROMIS scores and magnitude of improvement at the 6-week postoperative time point (slope = -0.6291, p < 0.001). Conclusion Patients with low preoperative PROMIS-PF scores demonstrated greater improvements at 6 weeks and 1 year. Clinicians should consider patients with low preoperative PROMIS-PF scores to be in the unique position to potentially experience larger postoperative improvement magnitudes than patients with higher preoperative PROMIS-PF scores.