P145. Evaluation of health-related quality of life improvement in patients undergoing spine vs adult reconstructive surgery after 1 year follow-up

Abstract

BACKGROUND CONTEXT Patient Reported Outcome Information System (PROMIS) provides a tailored ability to compare different procedures. This study compares PROMIS results for patients undergoing common single-level spinal surgery, total hip arthroplasty (THA) and total knee arthroplasty (TKA) procedures with minimum 1 Year Follow-Up (FU). PURPOSE To evaluate the efficacy of spine surgery compared to adult reconstructive surgery. STUDY DESIGN/SETTING Single-center retrospective cohort study PATIENT SAMPLE A total of 98 spine patients (32 Laminectomy, 22 MLD, 44 TLIF) and 147 RECON patients (50 THA and 97 TKA). OUTCOME MEASURES Patient demographics, Physical-Function (PF), Pain-Intensity (PI) and Pain-Interference (P-IF). METHODS Included: Patients>18 years old who underwent single level spine surgery (Lami, MLD, TLIF) or RECON surgery with Baseline (BL) & 1Y PROMIS scores of PF, P-IF, and PI, which were grouped based on surgery type. Excluded: patients who underwent both single level spine and RECON surgeries. Paired t-tests calculated differences in BL, 1Y, and change in PROMIS scores for spine vs each RECON procedure. RESULTS Age and gender were similar between spine (Age=58.92±13.69; 45.91% Female) and RECON (Age=65.9±8.6; 63.95% Female) patients. Spine patients undergoing Laminectomy(PF: 13.3±15.4, P-IF: 90.9±7.3, PI:56.2±6.6), MLD (PF:9.8±16.1,P-IF:94.2±6.4,PI:61.2±6.5) , or TLIF (PF:10.6±10.9,P-IF:91.8±13.0,PI:56.4±6.5) had more disability and pain at BL than either THA(PF: 36.0±4.7,P-IF:64.0±5.5,PI:54.2±6.2) or TKA(PF:35.5±3.9,P-IF:63.6±6.2,PI:53.3±6.6)patients according to all 3 PROMIS categories. When assessing all lumbar surgery patients with RECON, spine patients had greater improvements in PF (15.5±21 vs 6.8±6.3, p<0.001) and P-IF (-17.2±21.3 vs -10.0±9.5, p=0.002) domains except PI (-7.2±9.9 vs -9.8±9.5,p=0.038). CONCLUSIONS Patients undergoing single level spinal surgery had worse baseline disability and pain compared to those undergoing recon surgery. PROMIS improvement is equivalent, and often greater in the spine patients compared to RECON. Although patients undergoing spine surgery had lower initial PROMIS scores than RECON patients, spine patients showed at least as good or better improvement at a 1Y postoperative time point. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs. Patient Reported Outcome Information System (PROMIS) provides a tailored ability to compare different procedures. This study compares PROMIS results for patients undergoing common single-level spinal surgery, total hip arthroplasty (THA) and total knee arthroplasty (TKA) procedures with minimum 1 Year Follow-Up (FU). To evaluate the efficacy of spine surgery compared to adult reconstructive surgery. Single-center retrospective cohort study A total of 98 spine patients (32 Laminectomy, 22 MLD, 44 TLIF) and 147 RECON patients (50 THA and 97 TKA). Patient demographics, Physical-Function (PF), Pain-Intensity (PI) and Pain-Interference (P-IF). Included: Patients>18 years old who underwent single level spine surgery (Lami, MLD, TLIF) or RECON surgery with Baseline (BL) & 1Y PROMIS scores of PF, P-IF, and PI, which were grouped based on surgery type. Excluded: patients who underwent both single level spine and RECON surgeries. Paired t-tests calculated differences in BL, 1Y, and change in PROMIS scores for spine vs each RECON procedure. Age and gender were similar between spine (Age=58.92±13.69; 45.91% Female) and RECON (Age=65.9±8.6; 63.95% Female) patients. Spine patients undergoing Laminectomy(PF: 13.3±15.4, P-IF: 90.9±7.3, PI:56.2±6.6), MLD (PF:9.8±16.1,P-IF:94.2±6.4,PI:61.2±6.5) , or TLIF (PF:10.6±10.9,P-IF:91.8±13.0,PI:56.4±6.5) had more disability and pain at BL than either THA(PF: 36.0±4.7,P-IF:64.0±5.5,PI:54.2±6.2) or TKA(PF:35.5±3.9,P-IF:63.6±6.2,PI:53.3±6.6)patients according to all 3 PROMIS categories. When assessing all lumbar surgery patients with RECON, spine patients had greater improvements in PF (15.5±21 vs 6.8±6.3, p<0.001) and P-IF (-17.2±21.3 vs -10.0±9.5, p=0.002) domains except PI (-7.2±9.9 vs -9.8±9.5,p=0.038). Patients undergoing single level spinal surgery had worse baseline disability and pain compared to those undergoing recon surgery. PROMIS improvement is equivalent, and often greater in the spine patients compared to RECON. Although patients undergoing spine surgery had lower initial PROMIS scores than RECON patients, spine patients showed at least as good or better improvement at a 1Y postoperative time point.