학술논문
The Duration of Symptoms Influences Outcomes After Lumbar Microdiscectomies: A Michigan Spine Surgery Improvement Collaborative.
Document Type
Academic Journal
Author
Kasir R; Department of Orthopedic Surgery, Beaumont Hospital, Royal Oak, MI, USA.; Zakko P; Department of Orthopedic Surgery, Beaumont Hospital, Royal Oak, MI, USA.; Hasan S; Oakland University William Beaumont School of Medicine, Rochester, MI, USA.; Aleem I; Department of Orthopedic Surgery, University of Michigan Ann Arbor, MI, USA.; Park D; Department of Orthopedic Surgery, Beaumont Hospital, Royal Oak, MI, USA.; Nerenz D; Department of Neurosurgery, Henry Ford Health System, Detroit, MI, USA.; Abdulhak M; Department of Neurosurgery, Henry Ford Health System, Detroit, MI, USA.; Perez-Cruz M; Department of Neurosurgery, Beaumont Health, Royal Oak, MI, USA.; Schwalb J; Department of Neurosurgery, Henry Ford Health System, Detroit, MI, USA.; Saleh ES; Department of Orthopedic Surgery, Beaumont Hospital, Royal Oak, MI, USA.; Easton R; Department of Orthopedic Surgery, Beaumont Hospital, Royal Oak, MI, USA.; Khalil JG; Department of Orthopedic Surgery, Beaumont Hospital, Royal Oak, MI, USA.
Source
Publisher: SAGE Publications Country of Publication: England NLM ID: 101596156 Publication Model: Print-Electronic Cited Medium: Print ISSN: 2192-5682 (Print) Linking ISSN: 21925682 NLM ISO Abbreviation: Global Spine J
Subject
Language
English
ISSN
2192-5682
Abstract
Study Design: Retrospective Cohort.
Objective: We investigate whether duration of symptoms a patient experiences prior to lumbar microdiscectomy affects pain, lifestyle, and return to work metrics after surgery.
Methods: A retrospective review of patients with a diagnosis of lumbar radiculopathy undergoing microdiscectomy was conducted using a statewide registry. Patients were grouped based on self-reported duration of symptoms prior to surgical intervention (Group 1: symptoms less than 3 months; Group 2: symptoms between 3 months and 1 year; and Group 3: symptoms greater than 1 year). Radicular pain scores, PROMIS PF Physical Function measure (PROMIS PF), EQ-5D scores, and return to work rates at 90 days, 1 year, and 2 years after surgery were compared using univariate and multivariate analysis.
Results: There were 2408 patients who underwent microdiscectomy for lumbar disc herniation for radiculopathy with 532, 910, and 955 in Groups 1, 2, and 3, respectively. Postoperative leg pain was lower for Group 1 at 90 days, 1 year, and 2 years compared to Groups 2 and 3 ( P < .05). Postoperative PROMIS PF and EQ-5D scores were higher for Group 1 at 90 days, 1 year, and 2 years compared to Groups 2 and 3 ( P < .05).
Conclusion: Patients with prolonged symptoms prior to surgical intervention experience smaller improvements in postoperative leg pain, PROMIS PF, and EQ-5D than those who undergo surgery earlier. Patients undergoing surgery within 3 months of symptom onset have the highest rates of return to work at 1 year after surgery.
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: All authors have no relationships related to this study specifically. Although BCBSM and MSSIC work collaboratively, the opinions, beliefs, and viewpoints expressed by the authors do not necessarily reflect the opinions, beliefs, and viewpoints of BCBSM or any of its employees. Support for MSSIC is provided by BCBSM and Blue Care Network as part of the BCBSM Value Partnerships program. Although BCBSM and MSSIC work collaboratively, the opinions, beliefs, and viewpoints expressed by the authors do not necessarily reflect the opinions, beliefs, and viewpoints of BCBSM or any of its employees. Support for MSSIC is provided by BCBSM and Blue Care Network as part of the BCBSM Value Partnerships program.
Objective: We investigate whether duration of symptoms a patient experiences prior to lumbar microdiscectomy affects pain, lifestyle, and return to work metrics after surgery.
Methods: A retrospective review of patients with a diagnosis of lumbar radiculopathy undergoing microdiscectomy was conducted using a statewide registry. Patients were grouped based on self-reported duration of symptoms prior to surgical intervention (Group 1: symptoms less than 3 months; Group 2: symptoms between 3 months and 1 year; and Group 3: symptoms greater than 1 year). Radicular pain scores, PROMIS PF Physical Function measure (PROMIS PF), EQ-5D scores, and return to work rates at 90 days, 1 year, and 2 years after surgery were compared using univariate and multivariate analysis.
Results: There were 2408 patients who underwent microdiscectomy for lumbar disc herniation for radiculopathy with 532, 910, and 955 in Groups 1, 2, and 3, respectively. Postoperative leg pain was lower for Group 1 at 90 days, 1 year, and 2 years compared to Groups 2 and 3 ( P < .05). Postoperative PROMIS PF and EQ-5D scores were higher for Group 1 at 90 days, 1 year, and 2 years compared to Groups 2 and 3 ( P < .05).
Conclusion: Patients with prolonged symptoms prior to surgical intervention experience smaller improvements in postoperative leg pain, PROMIS PF, and EQ-5D than those who undergo surgery earlier. Patients undergoing surgery within 3 months of symptom onset have the highest rates of return to work at 1 year after surgery.
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: All authors have no relationships related to this study specifically. Although BCBSM and MSSIC work collaboratively, the opinions, beliefs, and viewpoints expressed by the authors do not necessarily reflect the opinions, beliefs, and viewpoints of BCBSM or any of its employees. Support for MSSIC is provided by BCBSM and Blue Care Network as part of the BCBSM Value Partnerships program. Although BCBSM and MSSIC work collaboratively, the opinions, beliefs, and viewpoints expressed by the authors do not necessarily reflect the opinions, beliefs, and viewpoints of BCBSM or any of its employees. Support for MSSIC is provided by BCBSM and Blue Care Network as part of the BCBSM Value Partnerships program.