Jenkins Nathaniel W, Parrish James M, Nolte Michael T, Hrynewycz Nadia M, Brundage Thomas S, Singh Kern
Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St. Suite #300, Chicago, IL 60612 USA.
HSS J. 2020 Dec;16(Suppl 2):443-451. doi: 10.1007/s11420-020-09817-w. Epub 2020 Nov 9.
Development and validation of Veterans RAND 12-item (VR-12) physical component survey (PCS) has been established among civilian and veteran populations but it has not been examined among anterior cervical discectomy and fusion (ACDF) patients.
PURPOSES/QUESTIONS: We sought to validate legacy patient-reported outcome measures (PROMs) with VR-12 PCS among patients undergoing ACDF procedures.
A prospectively collected surgical registry was retrospectively evaluated for elective single or multi-level ACDFs performed for degenerative spinal pathologies from January 2014 to August 2019. Exclusion criteria included missing pre-operative surveys and surgery for trauma, metastasis, or infection. Demographic variables, baseline pathologies, and peri-operative variables were collected. A paired test evaluated the change from the pre-operative score to each post-operative timepoint for VR-12 PCS, the 12-item Short-Form Survey (SF-12) PCS, Patient-Reported Outcomes Measurement Information System physical function (PROMIS-PF), and Neck Disability Index (NDI). Minimal clinically important difference (MCID) achievement was calculated at each timepoint. Correlation was evaluated with a Pearson's correlation coefficient and time-independent partial correlation.
Of the 202 patients who underwent ACDF, 41.1% were female and the average age was 49.5 years. All PROMs had statistically significantly increased from baseline when compared with post-operative timepoints (12 weeks, 6 months, 1 year, and 2 years). MCID achievement rates increased through 2 years. All timepoints revealed strong VR-12 PCS correlations with SF-12 PCS, PROMIS-PF, and NDI scores.
VR-12 PCS was strongly correlated with the well-validated SF-12 PCS and NDI metrics as well as with the more recent PROMIS-PF. All PROMs demonstrated statistically significant improvement in patients post-operatively. VR-12 PCS is a valid measure of physical function among patients undergoing ACDF.
退伍军人兰德12项健康调查简表（VR-12）身体成分量表（PCS）已在平民和退伍军人人群中得到开发和验证，但尚未在前路颈椎间盘切除融合术（ACDF）患者中进行研究。
目的/问题：我们试图在接受ACDF手术的患者中，用VR-12 PCS验证传统的患者报告结局指标（PROMs）。
对2014年1月至2019年8月期间因退行性脊柱疾病进行的择期单节段或多节段ACDF手术的前瞻性收集的手术登记资料进行回顾性评估。排除标准包括术前调查缺失以及因创伤、转移或感染而进行的手术。收集人口统计学变量、基线病变和围手术期变量。采用配对t检验评估VR-12 PCS、12项简短健康调查（SF-12）PCS、患者报告结局测量信息系统身体功能（PROMIS-PF）和颈部功能障碍指数（NDI）从术前评分到每个术后时间点的变化。计算每个时间点的最小临床重要差异（MCID）达成率。采用Pearson相关系数和时间独立偏相关评估相关性。
在202例接受ACDF手术的患者中，41.1%为女性，平均年龄为49.5岁。与术后各时间点相比，所有PROMs从基线开始均有统计学显著增加。MCID达成率在2年内有所提高。所有时间点均显示VR-12 PCS与SF-12 PCS、PROMIS-PF和NDI评分之间存在强相关性。
VR-12 PCS与经过充分验证的SF-12 PCS和NDI指标以及较新的PROMIS-PF密切相关。所有PROMs在患者术后均显示出统计学显著改善。VR-12 PCS是ACDF患者身体功能的有效测量指标。
