Does Baseline Mental Health Influence Outcomes among Workers' Compensation Claimants Undergoing Minimally Invasive Transforaminal Lumbar Interbody Fusion?

Patel Madhav Rajesh; Jacob Kevin Chacko; Amin Kanhai S.; Ribot Max A.; Pawlowski Hanna; Prabhu Michael C.; Vanjani Nisheka Navin; Singh Kern

doi:10.31616/asj.2021.0388

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저자정보: Patel Madhav Rajesh (Department of Orthopaedic Surgery Rush University Medical Center Chicago IL USA) Jacob Kevin Chacko (Department of Orthopaedic Surgery Rush University Medical Center Chicago IL USA) Amin Kanhai S. (Department of Orthopaedic Surgery Rush University Medical Center Chicago IL USA) Ribot Max A. (Department of Orthopaedic Surgery Rush University Medical Center Chicago IL USA) Pawlowski Hanna (Department of Orthopaedic Surgery Rush University Medical Center Chicago IL USA) Prabhu Michael C. (Department of Orthopaedic Surgery Rush University Medical Center Chicago IL USA) Vanjani Nisheka Navin (Department of Orthopaedic Surgery Rush University Medical Center Chicago IL USA) Singh Kern (Orthopaedic Surgery Rush University Medical Center Chicago IL USA)

저널정보: 대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.17 No.1

발행연도: 2023.2

수록면: 96 - 108 (13page)

DOI: 10.31616/asj.2021.0388

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Study Design: This was a retrospective cohort study.Purpose: This study investigated the influence of preoperative mental health on patient-reported outcome measures (PROMs) and minimal clinically important difference (MCID) among workers’ compensation (WC) recipients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).Overview of Literature: No studies have evaluated the impact of preoperative mental functioning on outcomes following MIS TLIF among WC claimants.Methods: WC recipients undergoing single-level MIS TLIF were identified. PROMs of Visual Analog Scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), 12-item Short Form Physical and Mental Composite Scale (SF-12 PCS/MCS), and Patient-Reported Outcomes Measurement Information System Physical Function evaluated subjects preoperatively/postoperatively. Subjects were grouped according to preoperative SF-12 MCS: <41 vs. ≥41. Demographic/perioperative variables, PROMs, and MCID were compared using inferential statistics. Multiple regression was used to account for differences in spinal pathology.Results: The SF-12 MCS <41 and SF-12 MCS ≥41 groups included 48 and 45 patients, respectively. Significant differences in ΔPROMs were observed at SF-12 MCS at all timepoints, except at 6 months (p≤0.041, all). The SF-12 MCS <41 group had worse preoperative to 6-months SF-12 MCS, 12-weeks/6-months VAS back, 12-week VAS leg, and preoperative to 6-months ODI (p≤0.029, all). The SF-12 MCS <41 group had greater MCID achievement for overall ODI and 6-weeks/1-year/overall SF-12 MCS (p≤0.043, all); the SF-12 MCS ≥41 group had greater attainment for 6-month VAS back (p=0.004).Conclusions: Poorer mental functioning adversely affected the baseline and intermediate postoperative quality-of-life outcomes pertaining to mental health, back pain, and disability among WC recipients undergoing lumbar fusion. However, outcomes did not differ 1–2 years after surgery. While MCID achievement for pain and physical function was largely unaffected by preoperative mental health score, WC recipients with poorer baseline mental health demonstrated higher rates of overall clinically meaningful improvements for disability and mental health

#12-Item Short Form Mental Composite Scale #Transforaminal lumbar interbody fusion #Workers' compensation #Patient-reported outcome measures #Minimal clinically important difference

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