Wednesday, September 26, 2018 7:35 AM–9:00 AM ePosters

Abstract

BACKGROUND CONTEXT The primary goal of surgery for lumbar degenerative disease is to reduce pain and improve physical function. However, patients often experience problems in other areas of health and wellness. In setting expectations for outcomes of lumbar spine surgery, it is beneficial to understand how changes in pain and physical function may influence these other domains. PROMIS is a multidimensional assessment that measures spine patients’ pain, physical function, fatigue, anxiety, depression, sleep disturbance and social participation with a population mean of 50 (SD 10). PURPOSE To investigate whether treatment of pain and physical limitation with surgery for lumbar degenerative disease will result in improvements in other domains of health and wellness. STUDY DESIGN/SETTING Longitudinal study. PATIENT SAMPLE A total of 1,246 visits of 490 unique patients. OUTCOME MEASURES PROMIS domain change scores (preoperative vs. postoperative). METHODS Patients undergoing surgery for degenerative lumbar disease completed PROMIS surveys preoperatively and 6 weeks and 3, 6 and 12 months postoperatively. Between Dec. 2014 and Jan. 2018, PROMIS data was collected for 1,246 visits of 490 unique patients. Repeated measures logistic regression was used to calculate the odds of a meaningful improvement (MCID) in PROMIS domains given a 5-point improvement in either pain or physical function. RESULTS A 5-point decrease in pain was associated with a 59% increased odds of MCID in fatigue (95% CI 1.26–2.01, p= CONCLUSIONS Decreases in pain yield meaningful improvements in fatigue, anxiety, sleep disturbance and social participation. Additionally, gains in physical function result in meaningful improvements in both fatigue and social role participation. Although patients undergo lumbar spine surgery primarily due to pain and physical limitations, our results suggest that improvement in these domains will lead to gains in other areas of health and wellness.