Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
World Neurosurg. 2022 Aug;164:e649-e661. doi: 10.1016/j.wneu.2022.05.024. Epub 2022 May 13.
To compare patient-reported outcomes (PROMs), postoperative patient-reported satisfaction, and minimum clinically important difference (MCID) achievement after minimally invasive surgery lumbar decompression (MIS-LD) in patients stratified by their preoperative 12-Item Short-Form Mental Component Score (SF-12 MCS).
Patients who underwent single-level/multilevel MIS-LD were included. PROMs were administered preoperatively and 6 weeks/12 weeks/6 months/1 year postoperatively. Patients were grouped by preoperative SF-12 MCS. Demographic/perioperative characteristics were compared among groups using a χ and Student t test for categorical and continuous variables, respectively. Mean PROM and postoperative satisfaction scores were compared using an unpaired Student t test. PROM improvement within cohorts was assessed with paired-samples t test. MCID achievement rates were compared using χ analysis.
A total of 297 patients were included: 111 patients in SF-12 MCS <48.9 and 186 patients in the SF-12 MCS ≥48.9 cohort. Cohorts showed mean postoperative differences for visual analog scale (VAS) back score at 12 weeks, VAS leg score at 6 weeks/12 weeks, Oswestry Disability Index (ODI) at 6 weeks/12 weeks, SF-12 MCS at all postoperative time points, and 12-Item Short-Form Physical Component Score at 6 weeks/12 weeks (P < 0.022, all). Of patients in the SF-12 MCS <48.9 cohort, more achieved MCID for SF-12 MCS at all postoperative time points and ODI at 1 year (P < 0.023, all). More patients in the SF-12 MCS ≥48.9 cohort achieved MCID for VAS leg score at 12 weeks and 12-Item Short-Form Physical Component Score at 6 weeks (P < 0.038). Patients in the SF-12 MCS <48.9 cohort showed inferior postoperative satisfaction for VAS leg score at 6 weeks/12 weeks/1 year, VAS back score at 12 weeks, and ODI at all postoperative time points.
Patients with inferior mental health preoperatively showed worse mean short-term postoperative clinical outcome for leg/back pain, physical function and disability, short-term and long-term postoperative satisfaction for leg pain and disability, and long-term satisfaction for sleeping/lifting/walking/standing/sex/travel.
比较术前 12 项简短形式心理健康量表（SF-12 MCS）评分分层的微创腰椎减压术（MIS-LD）患者的患者报告结局（PROMs）、术后患者报告满意度和最小临床重要差异（MCID）的实现情况。
纳入接受单节段/多节段 MIS-LD 的患者。在术前和术后 6 周/12 周/6 个月/1 年时进行 PROMs 评估。根据术前 SF-12 MCS 将患者分为组。使用 χ²检验和学生 t 检验分别比较组间的分类和连续变量的人口统计学/围手术期特征。使用未配对学生 t 检验比较平均 PROM 和术后满意度评分。使用配对样本 t 检验评估队列内的 PROM 改善情况。使用 χ²分析比较 MCID 实现率。
共纳入 297 例患者：SF-12 MCS<48.9 的患者 111 例，SF-12 MCS≥48.9 的患者 186 例。队列在术后 12 周的视觉模拟量表（VAS）背部评分、术后 6 周/12 周的 VAS 腿部评分、Oswestry 残疾指数（ODI）、所有术后时间点的 SF-12 MCS 以及术后 6 周/12 周的 12 项简短形式身体成分评分方面显示出术后差异（P<0.022，均）。SF-12 MCS<48.9 队列中，更多患者在所有术后时间点和 1 年时达到 MCID 的 SF-12 MCS 和 ODI（P<0.023，均）。SF-12 MCS≥48.9 队列中，更多患者在术后 12 周 VAS 腿部评分和术后 6 周的 12 项简短形式身体成分评分达到 MCID（P<0.038）。SF-12 MCS<48.9 队列的患者在术后 6 周/12 周/1 年的 VAS 腿部评分、术后 12 周的 VAS 背部评分和所有术后时间点的 ODI 方面表现出较差的术后满意度。
术前心理健康状况较差的患者在腿部/背部疼痛、身体功能和残疾、腿部疼痛和残疾的短期和长期术后满意度以及睡眠/举重/行走/站立/性生活/旅行的长期满意度方面表现出较差的平均短期术后临床结局。
