Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St. Suite #300, Chicago, IL, 60612, USA.
Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St. Suite #300, Chicago, IL, 60612, USA.
J Clin Neurosci. 2024 May;123:36-40. doi: 10.1016/j.jocn.2024.03.017. Epub 2024 Mar 23.
No study has evaluated the preoperative impact of Veterans RAND-12 Physical Composite Score (VR-12 PCS) on anterior lumbar interbody fusion (ALIF) patients. This study examines its influence on physical function, mental health, pain, and disability outcomes. Two cohorts of ALIF patients with preoperative VR-12 PCS scores were formed using a single-surgeon registry: VR-12 PCS < 30 and VR-12 PCS ≥ 30. Demographics, perioperative characteristics, and patient-reported outcome measures (PROMs) were collected. PROMs of VR-12 PCS/Mental Composite Score (MCS), Short Form-12 (SF-12) PCS/MCS, Patient-Reported Outcomes Measurement Information System-Physical Function (PROMIS-PF), Patient Health Questionnaire-9 (PHQ-9), Visual Analog Scale-Back/Leg Pain (VAS-BP/LP), and Oswestry Disability Index (ODI) were collected pre/postoperatively up to 2-years. Demographics, perioperative characteristics, and preoperative PROMs were compared. Intercohort postoperative 6-week/final PROMs and improvements were compared. Of 80 patients, there were 41 in the VR-12 PCS < 30 cohort. Besides VR-12 PCS, VR-12 PCS < 30 patients reported inferior preoperative VR-12 MCS/SF-12 PCS/PROMIS-PF/PHQ-9/ODI scores (p ≤ 0.003, all). At 6-weeks postoperatively, VR-12 PCS < 30 reported inferior VR-12 PCS/SF-12 PCS/PROMIS-PF/PHQ-9 (p ≤ 0.030, all). There was greater improvement up to 6-weeks postoperatively in VR-12 PCS < 30 for VR-12 PCS/MCS and SF-12 PCS (p ≤ 0.020, all). VR-12 PCS < 30 reported superior improvement by final follow-up in VR-12 PCS/SF-12 PCS/PHQ-9 (p ≤ 0.006, all). MCID achievement rates were higher in VR-12 PCS < 30 for PHQ-9 and ODI (p ≤ 0.013, both). VR-12 PCS < 30 patients reported inferior postoperative physical function, mental health, and disability, yet superior magnitude of improvement in physical function and mental health. Rates of clinically meaningful improvement for VR-12 PCS < 30 were greater in mental health and disability.
尚无研究评估退伍军人 RAND-12 身体综合评分（VR-12 PCS）对前路腰椎间融合术（ALIF）患者的术前影响。本研究旨在探讨其对生理功能、心理健康、疼痛和残疾结局的影响。使用单外科医生注册处，根据术前 VR-12 PCS 评分将两组 ALIF 患者分为两组：VR-12 PCS<30 和 VR-12 PCS≥30。收集患者的人口统计学、围手术期特征和患者报告的结局测量（PROM）。收集 VR-12 PCS/心理综合评分（MCS）、简短健康调查量表 12 项（SF-12）PCS/MCS、患者报告的测量信息系统-身体功能（PROMIS-PF）、患者健康问卷-9（PHQ-9）、视觉模拟量表-腰背疼痛（VAS-BP/LP）和 Oswestry 残疾指数（ODI）的术前/术后 PROM，随访时间最长为 2 年。比较两组患者的人口统计学、围手术期特征和术前 PROM。比较两组患者术后 6 周/最终 PROM 及改善情况。在 80 名患者中，VR-12 PCS<30 组有 41 名患者。除 VR-12 PCS 外，VR-12 PCS<30 组患者报告术前 VR-12 MCS/SF-12 PCS/PROMIS-PF/PHQ-9/ODI 评分较差（p≤0.003，均）。术后 6 周时，VR-12 PCS<30 组患者 VR-12 PCS/SF-12 PCS/PROMIS-PF/PHQ-9 评分较差（p≤0.030，均）。至术后 6 周时，VR-12 PCS<30 组患者 VR-12 PCS/MCS 和 SF-12 PCS 改善幅度更大（p≤0.020，均）。至最终随访时，VR-12 PCS<30 组患者 VR-12 PCS/SF-12 PCS/PHQ-9 改善更显著（p≤0.006，均）。VR-12 PCS<30 组患者 PHQ-9 和 ODI 的 MCID 达标率更高（p≤0.013，均）。VR-12 PCS<30 组患者术后生理功能、心理健康和残疾较差，但生理功能和心理健康改善幅度更大。VR-12 PCS<30 组患者心理健康和残疾的临床改善率更高。
