The Influence of Preoperative Mental Health on PROMIS Physical Function Outcomes Following Minimally Invasive Transforaminal Lumbar Interbody Fusion

Yoo, Joon S; Hrynewycz, Nadia M; Brundage, Thomas S; Mogilevsky, Franchesca A; Shah, Holly C; Mehraban, Nasima; Singh, Kern

doi:10.1097/brs.0000000000003236

Cited by 14 publications

(17 citation statements)

References 37 publications

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“…This study found that patients with preoperative psychological disorder had corresponding worse physical function preoperatively as indicated by lower PROMIS PF scores at the preoperative baseline. This is consistent with previous literature that preoperative psychological disorder is associated with a patient's physical disability before spinal surgery [21][22][23][24]. Joon et al [21] demonstrated that patients with worse preoperative mental health were demonstrated to have worse preoperative PROMIS PF scores following minimally invasive transforaminal lumbar interbody fusion, what's more, patients with low mental health continue to report signi cantly worse physical function throughout the postoperative convalescence period.…”

Section: Discussionsupporting

confidence: 90%

The Influence of Preoperative Psychological States on Postoperative Outcomes Following Percutaneous Kyphoplasty(PKP)

Yang

Wang

et al. 2020

Preprint

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Abstract Background: Psychological disorder is widespread in patients with spinal conditions. There is limited investigation into the association between preoperative psychological symptoms(PPS) and postoperative outcomes following percutaneous kyphoplasty(PKP) in patients suffered osteoporotic vertebral compression fracture(OVCF) . Methods: This is a retrospective study performed on 224 patients undergoing PKP due to OVCF. Patients are divided into two cohorts base on preoperative psychological states described by Hamilton Depression Scale(HAMD) and Hamilton Anxiety Scale(HAMA). Pre- and postoperative physical function were evaluated by Patient-Reported Outcome Measurement Information System Physical Function(PROMIS PF), and Visual Analogue Scales(VAS) was used to to evaluate patients' back pain. Multiple linear regression model was used to investigate the association between preoperative psychological symptoms and postoperative outcomes.Results: 133(59.4%) patients have PPS, manifested as HAMD score ≥7 and/or HAMA score＞7. Patients with PPS have significantly worse PROMIS PF scores preoperatively (26.6±7.6 vs. 34.2±6.9, p=0.000), as well as within 6 monthes postoperatively, 1-week (31.1±6.5 vs. 37.4±7.2, p=0.000), 1-month (35.3±6.2 vs. 41.1±7.4, p=0.023), 3-months (38.5±8.3 vs. 45.8±8.5, p=0.005), and 6-months (42.8±8.0 vs. 51.2±9.1, p=0.000). Patients with PPS have higher VAS scores preoperatively(8.3±1.6 vs. 6.9±1.9, p=0.001), as well as within 1 month following operation, 1-week (6.2±1.7 vs. 4.1±1.2, p=0.000), 1-month (4.0±1.1 vs. 2.5±1.0, p=0.015).Conclusion: Psychological symptoms are widespread in OVCF patients undergoing PKP. Patients with poor preoperative psychological states not only demonstrated worse preoperative physical function and back pain, but also continued to have significantly worse postoperative outcomes.

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Section: Discussionsupporting

confidence: 90%

The Influence of Preoperative Psychological States on Postoperative Outcomes Following Percutaneous Kyphoplasty(PKP)

Yang

Wang

et al. 2020

Preprint

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“…The impact of pre-operative mental health on subsequent patient reported outcomes remain controversial in the literature. While Yoo et al showed that patients with worse pre-operative mental health scores had worse postoperative outcomes, 14 other studies have shown poor correlation of baseline mental health with post-surgical patient reported outcome measures. 15 - 17 …”

Section: Discussionmentioning

confidence: 96%

Preoperative Oswestry Disability Index Cannot Reliably Predict Patient Satisfaction After Single and Double Level Lumbar Transforaminal Interbody Fusion Surgery

Teo

Howe

Chan

et al. 2023

Geriatr Orthop Surg Rehabil

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Introduction The role of patient-reported outcomes in preoperative assessment is not well studied. There is recent interest in studying whether Patient-reported outcomes scores can be used either independently, or in conjunction with clinical findings, in the assessment of patients for surgery. Aims To investigate if improvement in clinically significant scores correlate with post-operative patient satisfaction in 1-2 level transforaminal lumbar interbody fusion (TLIF) surgery. We also aim to define a threshold Oswestry Disability Index (ODI) which correlate with achieving post-operative MCID and patient satisfaction. Methods 1001 patients who underwent single or double level TLIF (Minimally invasive and Open) in our institution with at least 2 years follow up were included in this study. We studied self-reported measures including patient satisfaction and ODI score. Results At 2-year follow-up, the overall mean ODI score improved from 49.7 ± 18.3 to 13.9 ± 15.2 ( P < 0.001) with 74.6% of patients meeting the MCID. Patient satisfaction was achieved in 95.3% of all patients. In the MIS group, the preoperative cut-off was determined to be 37.2 at maximal Youden index associated with AUC of 0.72 (95% CI 0.65-0.86). In the open group, the preoperative cut-off was determined to be 37.2 at maximal Youden index associated with AUC of 0.70 (95% CI 0.62-0.77). Using the preoperative cut-offs found, there was no significant difference in patient satisfaction in both MIS and open groups. Conclusions Overall, our patients undergoing TLIF had good 2-year ODI score improvement and patient satisfaction after surgery. While meeting the MCID for ODI score correlates with patients’ satisfaction postoperatively, 75% of patients not meeting the MCID for ODI score remained satisfied with the surgery. We are unable to define a threshold pre-operative ODI which correlates with achieving post-operative MCID and patient satisfaction.

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“…For MIS TLIF specifically, patients demonstrating worse preoperative mental health status had worse postoperative PROMIS-PF. All patients demonstrated similar levels of improvement from baseline for shorter timepoints; however, those with worse mental health status demonstrated worse postoperative improvement 1 year after MIS TLIF [ 14 ]. This trend was similarly found among patients with isthmic spondylolisthesis, as the mean pain and disability PROMs were lower and long-term improvements across PROMs were less frequent among patients presenting with poorer preoperative SF-12 MCS [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2023

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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 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.

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The Influence of Preoperative Mental Health on PROMIS Physical Function Outcomes Following Minimally Invasive Transforaminal Lumbar Interbody Fusion

Cited by 14 publications

References 37 publications

The Influence of Preoperative Psychological States on Postoperative Outcomes Following Percutaneous Kyphoplasty(PKP)

The Influence of Preoperative Psychological States on Postoperative Outcomes Following Percutaneous Kyphoplasty(PKP)

Preoperative Oswestry Disability Index Cannot Reliably Predict Patient Satisfaction After Single and Double Level Lumbar Transforaminal Interbody Fusion Surgery

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

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