Defining a Minimum Clinically Important Difference in Patient-Reported Outcome Measures in Lumbar Tubular Microdecompression Patients

Abstract

Background: Patient-reported outcome measures (PROMs) are critical tools used in the assessment and reporting of surgical outcomes. However, significant differences in PROM scores have not been shown to consistently correlate with clinical improvement from the physician or patient perspective. Defining a minimum clinically important difference (MCID) for PROMs offers interpretation of surgical outcomes with an emphasis on patient-centered feedback. The goal of this study was to define a MCID for the following PROMs in lumbar tubular microdecompression (LTMD) patients: the EuroQol-Five Dimensions (EQ-5D) index, Oswestry Disability Index (ODI), leg pain visual analog scale (VAS), and low back pain VAS. Methods: This study examined 235 index LTMD patients with PROMs collected at preoperative evaluation and 1year follow-up. Using an anchor-based approach with patient satisfaction index, a receiver operating characteristic analysis was performed to define a MCID in the EQ-5D index, ODI, leg pain VAS, and low back pain VAS. Results: The patients had a mean age of 65.18 6 12.81 years, and 47.7% were male. The MCID values for the EQ-5D, ODI, leg pain VAS, and low back pain VAS are 0.219, 15.0-16.5, 0.5, and 2.5-3.5, respectively. Conclusions: This study helps define a MCID for the EQ-5D index in LTMD patients. Given its ease of administration and economic relevance, further characterization of the EQ-5D index may warrant its use as a potential alternative or adjunct to the routinely collected PROMs following spine surgery.

A Comparison of Analgesic Efficacy of Triamcinolone vs Magnesium Sulfate as Adjuvants in Caudal Block in Patients with Low Back Pain: A Double-Blind Randomized Controlled Trial

“…In the magnesium group, VAS scores were lower compared to the triamcinolone group. However, these differences were statistically significant but not clinically meaningful (11). From a holistic perspective, it can be concluded that there were no significant differences in VAS scores, ODI values, or patient satisfaction.…”

Patient-Reported Outcomes and Reoperation Rates Following Lumbar Tubular Microdecompression: Six-year Follow-Up

“…LTM techniques utilized were the unilateral laminotomy (UL) to address central and ipsilateral lateral recess stenosis, the unilateral laminotomy for bilateral decompression (ULBD) to address central pathology, bilateral lateral recess pathology and contralateral foraminal stenosis, and the far lateral “transpedicular” decompression (FLD) to address ipsilateral foraminal stenosis. All procedures were performed by a single surgeon using previously described techniques 6,7,17,18…”

“…All procedures were performed by a single surgeon using previously described techniques. 6,7,17,18 For UL and ULBD, patients were positioned prone on a spine table. Lateral fluoroscopy was used to dock the METRx tubular retractor (Medtronic, Dublin, Ireland) to the appropriate lamina after a small paramedian incision was made and serial dilation performed; an 18-or 22mm-diameter tube was used.…”