Juneyoung L Chavez1, Christina A Porucznik2, Lisa H Gren2, Jian Guan3, Evan Joyce3, Darrel S Brodke4, Andrew T Dailey3, Mark A Mahan3, Robert S Hood3, Brandon D Lawrence4, William R Spiker4, Nicholas T Spina4, Erica F Bisson3. 1. Department of Neurosurgery, Clinical Neurosciences Center, University of Utah Health Sciences Center, Salt Lake City, Utah, USA. Electronic address: June.Yi@hsc.utah.edu. 2. Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA. 3. Department of Neurosurgery, Clinical Neurosciences Center, University of Utah Health Sciences Center, Salt Lake City, Utah, USA. 4. Department of Orthopaedic Surgery, University of Utah Health Sciences Center, Salt Lake City, Utah.
Abstract
BACKGROUND: We previously reported inpatient and 30-day postoperative patient-reported outcomes (PROs) of a controlled, non-crossover pilot study utilizing preoperative mindfulness-based stress reduction (MBSR) training for lumbar spine surgery. Our goal here was to assess 3- and 12-month postoperative PROs of preoperative MBSR in lumbar spine surgery for degenerative disease. METHODS: Intervention group participants were prospectively enrolled in a preoperative online MBSR course. A comparison standard care-only group was one-to-one matched retrospectively by age, sex, surgery type, and prescription opioid use. Three- and 12-month postoperative PROs for pain, disability, quality of life, and opioid use were compared within and between groups. Regression models were used to assess whether MBSR use predicted outcomes. RESULTS: Twenty-four participants were included in each group. At 3 months, follow-up was 87.5% and 95.8% in the comparison and intervention groups, respectively. In the intervention group, mean PROMIS-PF was significantly higher while mean PROMIS-PI and ODI were significantly lower. The change from baseline in mean PROMIS-PF and PROMIS-PI were significantly greater than in the comparison group. At 12 months, follow-up was 58.3% and 83.3% in the comparison and intervention groups, respectively. In the intervention group, mean PROMIS-PI was significantly lower and change in mean PROMIS-PI from baseline was significantly greater. MBSR use was a significant predictor of change in PROMIS-PF at 3 months and in PROMIS-PI at 12 months. No adverse events were reported. CONCLUSIONS: Three- and 12-month results suggest preoperative MBSR may have pain-control benefits in lumbar spine surgery.
BACKGROUND: We previously reported inpatient and 30-day postoperative patient-reported outcomes (PROs) of a controlled, non-crossover pilot study utilizing preoperative mindfulness-based stress reduction (MBSR) training for lumbar spine surgery. Our goal here was to assess 3- and 12-month postoperative PROs of preoperative MBSR in lumbar spine surgery for degenerative disease. METHODS: Intervention group participants were prospectively enrolled in a preoperative online MBSR course. A comparison standard care-only group was one-to-one matched retrospectively by age, sex, surgery type, and prescription opioid use. Three- and 12-month postoperative PROs for pain, disability, quality of life, and opioid use were compared within and between groups. Regression models were used to assess whether MBSR use predicted outcomes. RESULTS: Twenty-four participants were included in each group. At 3 months, follow-up was 87.5% and 95.8% in the comparison and intervention groups, respectively. In the intervention group, mean PROMIS-PF was significantly higher while mean PROMIS-PI and ODI were significantly lower. The change from baseline in mean PROMIS-PF and PROMIS-PI were significantly greater than in the comparison group. At 12 months, follow-up was 58.3% and 83.3% in the comparison and intervention groups, respectively. In the intervention group, mean PROMIS-PI was significantly lower and change in mean PROMIS-PI from baseline was significantly greater. MBSR use was a significant predictor of change in PROMIS-PF at 3 months and in PROMIS-PI at 12 months. No adverse events were reported. CONCLUSIONS: Three- and 12-month results suggest preoperative MBSR may have pain-control benefits in lumbar spine surgery.