STUDY DESIGN: A retrospective study using prospectively collected registry data. OBJECTIVE: Examine the influence of preoperative mental health on outcomes after Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS-TLIF). SUMMARY OF BACKGROUND DATA: Prior studies investigating the relationship between mental health and outcomes after lumbar spine surgery included small cohorts with short follow-up and heterogenous fusion techniques. The effect of MIS-TLIF on mental health also remains unclear. METHODS: Prospectively collected registry data of 226 patients who underwent single-level MIS-TLIF at a single institution were reviewed. Patients had completed 5-year follow-up data and were assigned into propensity score-matched groups: poor baseline mental health, that is, low Mental Component Summary (MCS) (<50, n=113) and normal baseline mental health, that is, high MCS (≥50, n=113). Outcomes assessed were visual analog scale for back pain (BP), leg pain (LP), Oswestry Disability Index (ODI), Short-Form 36, North American Spine Society-Neurogenic Symptoms (NS), return to work, return to function, satisfaction, and expectation fulfillment. Length of operation and length of stay were recorded. RESULTS: Preoperative MCS was 40.6±8.2 and 58.5±5.4 in the low and high MCS groups, respectively, after propensity score matching (P<0.001). At 5 years, the high MCS group had significantly lower LP (P=0.020) and NS (P=0.009). Despite a significantly poorer baseline (44.3 vs. 38.7, P=0.007) and 6-month ODI (20.3 vs. 15.7, P=0.018) in the low MCS group, both groups achieved a comparable ODI at 5 years (P=0.084). There was no significant difference in proportion that achieved minimal clinically important difference for ODI, PCS, BP, and LP (P>0.05). Both groups reported similar proportions that return to work. However, the low MCS group had a smaller proportion of patients that return to function at 5 years (P=0.025). CONCLUSIONS: Although patients with poorer baseline mental health had greater pain and worse NS preoperatively and up to 5 years postoperatively, a similar proportion experienced a clinically significant improvement in all outcomes. LEVEL OF EVIDENCE: Level III-nonrandomized cohort study.
STUDY DESIGN: A retrospective study using prospectively collected registry data. OBJECTIVE: Examine the influence of preoperative mental health on outcomes after Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS-TLIF). SUMMARY OF BACKGROUND DATA: Prior studies investigating the relationship between mental health and outcomes after lumbar spine surgery included small cohorts with short follow-up and heterogenous fusion techniques. The effect of MIS-TLIF on mental health also remains unclear. METHODS: Prospectively collected registry data of 226 patients who underwent single-level MIS-TLIF at a single institution were reviewed. Patients had completed 5-year follow-up data and were assigned into propensity score-matched groups: poor baseline mental health, that is, low Mental Component Summary (MCS) (<50, n=113) and normal baseline mental health, that is, high MCS (≥50, n=113). Outcomes assessed were visual analog scale for back pain (BP), leg pain (LP), Oswestry Disability Index (ODI), Short-Form 36, North American Spine Society-Neurogenic Symptoms (NS), return to work, return to function, satisfaction, and expectation fulfillment. Length of operation and length of stay were recorded. RESULTS: Preoperative MCS was 40.6±8.2 and 58.5±5.4 in the low and high MCS groups, respectively, after propensity score matching (P<0.001). At 5 years, the high MCS group had significantly lower LP (P=0.020) and NS (P=0.009). Despite a significantly poorer baseline (44.3 vs. 38.7, P=0.007) and 6-month ODI (20.3 vs. 15.7, P=0.018) in the low MCS group, both groups achieved a comparable ODI at 5 years (P=0.084). There was no significant difference in proportion that achieved minimal clinically important difference for ODI, PCS, BP, and LP (P>0.05). Both groups reported similar proportions that return to work. However, the low MCS group had a smaller proportion of patients that return to function at 5 years (P=0.025). CONCLUSIONS: Although patients with poorer baseline mental health had greater pain and worse NS preoperatively and up to 5 years postoperatively, a similar proportion experienced a clinically significant improvement in all outcomes. LEVEL OF EVIDENCE: Level III-nonrandomized cohort study.
Authors: Timothy J Hartman; James W Nie; Keith R MacGregor; Omolabake O Oyetayo; Eileen Zheng; Kern Singh Journal: J Clin Orthop Trauma Date: 2022-09-11
Authors: Rafa Rahman; Bo Zhang; Nicholas S Andrade; Alvaro Ibaseta; Khaled M Kebaish; Lee H Riley; David B Cohen; Amit Jain; Sang H Lee; Daniel M Sciubba; Richard L Skolasky; Brian J Neuman Journal: Clin Spine Surg Date: 2021-12-01 Impact factor: 1.876