Impact of preoperative symptom duration in patients undergoing lateral lumbar interbody fusion

Background Few studies have examined the influence of preoperative symptom duration on clinical outcomes in patients undergoing lateral lumbar interbody fusion (LLIF) for degenerative conditions. Methods Patients undergoing LLIF presenting with radiculopathy and/or neurogenic claudication were separ...

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Published in:	Acta neurochirurgica Vol. 165; no. 1; pp. 89 - 97
Main Authors:	Nie, James W., Hartman, Timothy J., Oyetayo, Omolabake O., MacGregor, Keith R., Zheng, Eileen, Parsons, Alexander W., Massel, Dustin H., Sarari, Arash J., Singh, Kern
Format:	Journal Article
Language:	English
Published:	Vienna Springer Vienna 01-01-2023 Springer Nature B.V
Subjects:	Back Pain - surgery Chronic Pain - etiology Clinical outcomes Humans Interventional Radiology Lumbar Vertebrae - surgery Malignancy Medicine Medicine & Public Health Minimally Invasive Surgery Neurology Neuroradiology Neurosurgery Original Article - Spine - Other Pain Pain Measurement Patients Radiculopathy - surgery Retrospective Studies Spinal cord Spinal Fusion - adverse effects Spine - Other Surgery Surgical Orthopedics Trauma Treatment Outcome Minimum clinically important difference Lateral lumbar interbody fusion Patient-reported outcome measures
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Summary:	Background Few studies have examined the influence of preoperative symptom duration on clinical outcomes in patients undergoing lateral lumbar interbody fusion (LLIF) for degenerative conditions. Methods Patients undergoing LLIF presenting with radiculopathy and/or neurogenic claudication were separated into two groups: preoperative symptom duration < 1-year (shorter duration) versus duration ≥ 1-year (longer duration). Patients undergoing surgery for trauma/malignancy/infection were excluded. Patient-reported outcome measures (PROMs) of Patient-Reported Outcomes Measurement Information System-Physical Function (PROMIS-PF), 12-Item Short Form Physical/Mental Component Score (SF-12 PCS/MCS), Patient Health Questionnaire-9 (PHQ-9), visual analog scale (VAS) back/leg, and Oswestry Disability Index (ODI) were collected at preoperative and postoperative time points. Results Eighty-two total patients, with 34 shorter-duration patients, were identified after propensity score matching for demographics. Longer-duration patients had higher estimated blood loss. All patients reported significant improvement in physical function, mental function, pain, and disability in at least one postoperative time point, except for SF-12 MCS in the shorter duration cohort. The longer duration cohort had higher MCID achievement in 12-week VAS back. Conclusion Patients undergoing LLIF demonstrated significant postoperative improvement in physical function, mental function, pain, and disability outcomes independent of preoperative symptom duration. Both cohorts, when compared by preoperative symptom duration, demonstrated similar postoperative PROM scores. Patients with longer preoperative symptom duration had higher 12-week leg pain MCID achievement. These findings suggest that delayed time to surgery may not lead to inferior clinical outcomes in patients undergoing LLIF for degenerative conditions.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0942-0940 0001-6268 0942-0940
DOI:	10.1007/s00701-022-05436-y