General Session: Thoraco-Lumbar Degenerative
Presented by: K. Yom - View Audio/Video Presentation (Members Only)
B. Mayo(1), D. Massel(1), D. Bohl(1), A. Narain(1), F. Hijji(1), K. Yom(1), K. Kudaravalli(1), K. Singh(1)
(1) Rush University Medical Center, Orthopaedic Surgery, Chicago, IL, United States
Introduction: Prior literature has associated poor preoperative mental health with inferior patient-reported outcomes following spinal procedures. The purpose of this study is to test for association of preoperative Short Form-12 (SF-12) Mental Health Composite Score (MCS) with improvements in Oswestry Disability Index (ODI) and back and leg pain following a minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).
Methods: A retrospective analysis of patients who underwent a primary, one-level MIS TLIF was reviewed. Patients were excluded if they did not have complete patient-reported outcome data for the preoperative or all postoperative visits. Preoperative SF-12 MCS was tested for association with preoperative ODI, back Visual Analog Scale (VAS), and leg VAS. Preoperative MCS was then tested for association with changes in ODI, back and leg VAS from the preoperative to postoperative visits. These tests were conducted using multivariate regression controlling for baseline characteristics as well as for the preoperative score for the patient-reported outcome being assessed.
Results: A total of 71 patients were included in the analysis. At baseline, higher preoperative MCS was negatively associated with lower preoperative ODI (Coefficient: -0.62, p< 0.001), preoperative back VAS (-0.07, p=0.003), and preoperative leg VAS (-0.06, p=0.019). However, there was no association between preoperative MCS and improvement in ODI, back VAS, or leg VAS at any of the postoperative time points (p>0.05 for each). The percent of patients achieving a minimum clinically important difference at 6 months did not differ between the bottom and top MCS quartiles (p>0.05 for each).
Conclusions: The results of this study suggest that better preoperative mental health is associated with lower perceived preoperative disability and with decreased severity of back and leg pain. In contrast to other studies, the present study was unable to demonstrate that preoperative mental health is predictive of improvement in patient reported outcomes at any postoperative time point following an MIS TLIF.