General Session: MIS - Hall F
Presented by: B. Haws
B. Haws(1), B. Khechen(1), K. Cardinal(1), J. Guntin(1), D. Bohl(1), K. Singh(1)
(1) Rush University Medical Center, Orthopaedic Surgery, Chicago, IL, United States
Introduction: Patient-reported outcomes are commonly used to evaluate treatment efficacy. Inefficiencies in standard measurement tools often prove to be a barrier to data collection. The Patient-Reported Outcomes Measurement Information System (PROMIS) was developed to overcome these limitations. This tool implements computer adaptive testing, which allows for assessment of physical function in fewer questions than "static" metrics. Within spine surgery populations, moderate to strong correlations with Oswestry Disability Index (ODI) and Short Form (SF)-36 have been reported for PROMIS. However, data is limited regarding the efficacy of this tool in patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).
Methods: A prospectively-maintained surgical registry of patients undergoing primary, 1-2 level MIS TLIF from 2015-2016 was retrospectively reviewed. Patients with incomplete PROMIS data were excluded. Postoperative changes in PROMIS physical function scores at 6-weeks, 12-weeks, and 6-months were analyzed using paired t-tests. PROMIS scores were compared to traditional outcome measures including SF-12 physical function, ODI, and Visual Analog Scale (VAS) back and leg scores. Correlations were tested using Pearson correlation coefficient with strength of association interpreted as follows: 0.1 ≤ |r| < 0.3, small; 0.3 ≤ |r| < 0.5, moderate; and |r| ≥ 0.5, large. Statistical significance was set at p< 0.05.
Results: 74 patients were included in this analysis after exclusion of those without PROMIS scores. The average preoperative PROMIS score was 35.92 ± 6.98. There were significant improvements in postoperative PROMIS scores at 12 weeks (41.33, p=< 0.001) and 6 months (43.58, p< 0.001). PROMIS scores demonstrated significant correlation with SF-12, ODI, and VAS leg scores (p< 0.05). Strong associations with PROMIS scores were observed for SF-12 (r range: 0.650 to 0.854), ODI (r range: -0.525 to -0.831), and 6 month VAS back (r= -0.693).
Conclusions: Physical function as measured by PROMIS improves significantly at 12 weeks and 6 months following MIS TLIF. Additionally, PROMIS scores demonstrate strong correlations with SF-12 and ODI scores. These results suggest that PROMIS scores may be used as a valid assessment of physical function in MIS TLIF. Further work is required to determine the full benefits of this measure in specific spine populations.