233. Ambulatory single-level posterior cervical foraminotomy for cervical radiculopathy: a propensity matched analysis of complication rates

Bovonratwet, Patawut; Retzky, Julia; Chen, Aaron; Ondeck, Nathaniel T.; Samuel, Andre M.; Qureshi, Sheeraz A.; Grauer, Jonathan N.; Albert, Todd J.

doi:10.1016/j.spinee.2021.05.440

Cited by 1 publication

(1 citation statement)

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“…Postsurgical outcome measures of major interest to spine surgeons and patients include postoperative pain and narcotics utilization. [10][11][12][13][14] These variables are especially important to consider for ambulatory procedures, 15 such as lumbar microdiscectomy, since they may dictate case order, possible overnight admission, and outpatient opioid prescriptions. Currently, data on clinical utility of preoperative PROMIS-PF in predicting immediate postoperative pain, narcotics consumption, and other long-term PROMs after lumbar microdiscectomy is lacking.…”

Section: Introductionmentioning

confidence: 99%

Association Between Patient Reported Outcomes Measurement Information System Physical Function With Postoperative Pain, Narcotics Consumption, and Patient-Reported Outcome Measures Following Lumbar Microdiscectomy

Bovonratwet

Vaishnav

Mok

et al. 2022

Global Spine Journal

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Study Design Retrospective cohort study. Objective To determine association between preoperative Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF) scores with postoperative pain, narcotics consumption, and patient-reported outcome measures (PROMs) following single-level lumbar microdiscectomy. Methods Consecutive patients who underwent single-level lumbar microdiscectomy were identified from May 2017–May 2020. Patients were grouped by their preoperative PROMIS-PF scores: mild disability (score≥40), moderate disability (score 30-39.9), and severe disability (score<30). Preoperative PROMIS-PF subgroups were tested for association with inpatient postoperative pain, total inpatient narcotics consumption, time to narcotic use cessation as well as improvements in postoperative PROMIS-PF, ODI, VAS-Leg Pain, VAS-Back Pain, SF-12 Physical Component Score (PCS), SF-12 Mental Component Score (MCS) at 2-, 6-, 12-weeks, 6-month, 1-year, 2-year follow-up. Results A total of 127 patients were included. Patients with greater disability reported higher inpatient maximum Visual Analog Scale (VAS) pain scores ( P = .023) and total inpatient narcotics consumption ( P = .008) but no difference in time to narcotic cessation after surgery ( P = .373). However, patients with greater preoperative disability also demonstrated greater improvement from baseline in PROMIS-PF, ODI, SF-12 PCS, and SF-12 MCS at 2-week follow-up ( P < .05). These higher improvements from baseline for patients with greater preoperative disability were sustained for PROMIS-PF, ODI, and VAS-Leg Pain at 2-year follow-up ( P < .05) Conclusions Patients with greater preoperative disability, as measured by PROMIS-PF, had increased inpatient postoperative pain and narcotics consumption, but also higher improvement from baseline in long-term PROMs. This data can be utilized for patient counseling and setting expectations.

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