Abstract
To conduct a preliminary analysis on the impact of time to surgery (TTS) and duration of symptoms (DOS) on clinical outcomes in workers' compensation patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). Patients using workers' compensation insurance undergoing primary, single-level MIS TLIF were identified. Patient-reported outcome measures (PROMs) were administered at preoperative/6-week/12-week/6-month postoperative time points and included visual analog scale (VAS) back/VAS leg/Oswestry Disability Index/12-Item Short-Form Physical Composite Score/12-Item Short-Form Mental Composite Score. Patients were grouped by TTS: <90 days, 90-179 days, and ≥180 days. Demographics were compared by χ2; perioperative characteristics, mean PROMs, and postoperative improvement (ΔPROM) were compared using 1-way analysis of variance. Minimum clinically important difference (MCID) achievement rates were compared using simple logistic regression. A secondary analysis was performed by grouping patients by DOS: <180 days, 180-364 days, and ≥365 days. Mean PROMs, ΔPROMs, and MCID achievement were similarly compared between DOS groups using 1-way analysis of variance and logistic regression. A total of 193 patients were included. Prevalence of herniated nucleus pulposus and initial appointment type were significantly associated with TTS (P < 0.042, all). No significant differences in mean PROMs or ΔPROMs were observed among TTS groups. MCID achievement was significantly lower for VAS back at 6 months in the longest TTS group. Mean PROMs were significantly different based on DOS for VAS leg at 6 weeks only. MCID achievement was significantly lower for the longest DOS group for VAS leg at 6 months only. ΔPROMs did not significantly differ among DOS groups. Neither TTS nor DOS was significantly associated with MIS TLIF outcomes. Workers' compensation patients may achieve similar clinical improvement even with longer symptom burden and substantial delays in operative treatment.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
