Bond Michael, Charest-Morin Raphaële, Street John, Fisher Charles, Dea Nicolas, Singh Supriya, Paquet Jerome, Abraham Edward, Bailey Christopher, Weber Michael, Nataraj Andrew, Attabib Najmedden, Kelly Adrienne, Rampersaud Raja, Manson Neil, Phan Phillippe, Thomas Ken, Soroceanu Alex, LaRue Bernard, Ahn Henry, Marion Travis, Christie Sean, Glennie Andrew, Zhi Wang, Hall Hamilton, Sutherland Jason M
Centre for Health Services and Policy Research, University of British Columbia, Vancouver, Canada.
Combined Neurosurgical and Orthopaedic Spine Program, Vancouver General Hospital, Vancouver, Canada.
Global Spine J. 2025 May;15(4):2118-2128. doi: 10.1177/21925682241287463. Epub 2024 Sep 25.
Study DesignRetrospective cohort study.ObjectivesThe impact of delayed access to operative treatment on patient reported outcomes (PROs) for lumbar degenerative conditions remains unclear. The goal of this study is to evaluate the association between wait times for elective lumbar spine surgery and post-operative PROs.MethodsThis study is a retrospective analysis of patients surgically treated for a degenerative lumbar conditions. Wait times were calculated from primary care referral to surgery, termed the cumulative wait time (CWT). CWT benchmarks were created at 3, 6 and 12 months. A multivariable logistic regression model was used to measure the associations between CWT and meeting the minimally clinically important difference (MCID) for the Oswestry Disability Index (ODI) score at 12 months post-operatively.ResultsA total of 2281 patients were included in the study cohort. The average age was 59.4 years (SD 14.8). The median CWT was 43.1 weeks (IQR 17.8 - 60.6) and only 30.9% had treatment within 6 months. Patients were more likely achieve the MCID for the ODI at 12 months post-operatively if they had surgery within 6 months of referral from primary care (OR 1.22; 95% CI 1.11 - 1.34). This relationship was also found at a benchmark CWT time of 3 months (OR 1.33; 95% CI 1.15 - 1.54) though not at 12 months (OR 1.08; 95% CI 0.97 - 1.20).ConclusionsPatients who received operative treatment within a 3- and 6-month benchmark between referral and surgery were more likely to experience noticeable improvement in post-operative function.
研究设计
回顾性队列研究。
目的
延迟接受手术治疗对腰椎退行性疾病患者报告结局（PROs）的影响尚不清楚。本研究的目的是评估择期腰椎手术等待时间与术后PROs之间的关联。
方法
本研究是对接受腰椎退行性疾病手术治疗患者的回顾性分析。等待时间从初级保健转诊至手术计算得出，称为累积等待时间（CWT）。CWT基准设定为3个月、6个月和12个月。采用多变量逻辑回归模型来衡量CWT与术后12个月时达到奥斯威斯功能障碍指数（ODI）评分的最小临床重要差异（MCID）之间的关联。
结果
研究队列共纳入2281例患者。平均年龄为59.4岁（标准差14.8）。CWT中位数为43.1周（四分位间距17.8 - 60.6），只有30.9%的患者在6个月内接受治疗。如果患者在从初级保健转诊后6个月内接受手术，则更有可能在术后12个月时达到ODI的MCID（比值比1.22；95%置信区间1.11 - 1.34）。在3个月的CWT基准时间也发现了这种关系（比值比1.33；95%置信区间1.15 - 1.54），但在12个月时未发现（比值比1.08；95%置信区间0.97 - 1.20）。
结论
在转诊和手术之间3至六个月基准时间内接受手术治疗的患者，术后功能更有可能有显著改善。
