Surgical Resection of Intradural Extramedullary Spinal Tumors: Patient-Reported Outcomes and Minimum Clinically Important Difference

Zuckerman, Scott L.; Chotai, Silky; Devin, Clinton J.; Parker, Scott L.; Stonko, David P.; Wick, Joseph; Hale, Andrew T.; McGirt, Matthew J.; Cheng, Joseph

doi:10.1016/j.spinee.2016.07.246

Cited by 8 publications

(24 citation statements)

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“…Few studies have discussed healthcare utilization associated with intradural spinal tumors 14,15,24,41 as compared to multiple studies assessing costs in the treatment of metastatic epidural spinal cord compression. [25][26][27]42,43 Sharma et al 14 reported that the mean total hospital charges for treating intramedullary spine tumors in the National Inpatient Sample from 2003 to 2010 was $61 157.…”

Section: Discussionmentioning

confidence: 99%

“…The data on PROs, resource utilization, and cost following surgery for spine tumors are sparse. 1,[22][23][24] The majority of resource utilization studies in spinal oncology are restricted to metastatic populations. [25][26][27] In this analysis, we set out to report 1-year PROs, resource utilization, and cost associated with surgical resection of IDEM tumors.…”

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Healthcare Resource Utilization and Patient-Reported Outcomes Following Elective Surgery for Intradural Extramedullary Spinal Tumors

et al. 2017

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BACKGROUND:Healthcare resource utilization and patient-reported outcomes (PROs) for intradural extramedullary (IDEM) spine tumors are not well reported. OBJECTIVE: To analyze the PROs, costs, and resource utilization 1 year following surgical resection of IDEM tumors. METHODS: Patients undergoing elective spine surgery for IDEM tumors and enrolled in a single-center, prospective, longitudinal registry were analyzed. Baseline and postoperative 1-year PROs were recorded. One-year spine-related direct and indirect healthcare resource utilization was assessed. One-year resource use was multiplied by unit costs based on Medicare national payment amounts (direct cost). Patient and caregiver workday losses were multiplied by the self-reported gross-of-tax wage rate (indirect cost). RESULTS: A total of 38 IDEM tumor patients were included in this analysis. There was significant improvement in quality of life (EuroQol-5D), disability (Oswestry and Neck Disability Indices), pain (Numeric rating scale pain scores for back/neck pain and leg/arm pain), and general physical and mental health (Short-form-12 health survey, physical and mental component scores) in both groups 1 year after surgery (P < .0001). Eighty-seven percent (n = 33) of patients were satisfied with surgery. The 1-year postdischarge resource utilization including healthcare visits, medication, and diagnostic cost was $4111 ± $3596. The mean total direct cost was $23 717 ± $7412 and indirect cost was $5544 ± $4336, resulting in total 1-year cost $29 177 ± $9314. CONCLUSION: Surgical resection of the IDEM provides improvement in patient-reported quality of life, disability, pain, general health, and satisfaction at 1 year following surgery. Furthermore, we report the granular costs of surgical resection and healthcare resource utilization in this population.

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Healthcare Resource Utilization and Patient-Reported Outcomes Following Elective Surgery for Intradural Extramedullary Spinal Tumors

et al. 2017

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“…'Resilience to disease is a process of positive adaptation despite the loss of health; it involves the development of vitality and skills to overcome the negative effects of adversity, risks, and vulnerability caused by disease' [7]. Previous studies have shown that the family caregivers of patients with spinal tumours often have poor quality of life and face immense psychological and economic stress [8,9]. Our previous study showed that caregivers' monthly income can increase family caregivers' burden [10].…”

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Factors related to the burden of family caregivers of elderly patients with spinal Tumours in Northwest China

et al. 2020

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Background: Family caregivers of elderly patients with spinal tumours experience considerable pain and burden during the care process. This study aims to investigate the factors associated with caregiver burden in family caregivers of elderly patients with spinal tumours. Methods: A total of 220 elderly patients with spinal tumours (age ≥ 65 years) hospitalized at the spine centre of our hospital from January 2015 to December 2017 and their family caregivers were recruited for this cross-sectional study. All participants completed a sociodemographic questionnaire. Caregiver burden, social support and selfefficacy were assessed by the Chinese version of the Zarit Burden Interview (ZBI), the Social Support Rating Scale (SSRS) and the General Self-Efficacy Scale (GSE), respectively. The factors related to caregiver burden were analysed by multivariate analysis. P < 0.05 was considered statistically significant. Results: The 216 elderly patients with spinal tumours were 71.59 ± 8.49 years old, and their caregivers were 70.46 ± 9.13 years old. A total of 170 patients were cared for by their spouses, who accounted for 78.7% of all caregivers. The ZBI score for the family caregivers was 35.5 ± 7.5, and most caregivers (84.5%) reported a moderate or heavy burden. The factors related to caregiver burden included patient paralysis, the primary cancer site, chemotherapy and/or radiation, cognitive dysfunction, functional status, monthly income, pain score, caregivers' SSRS score, and GSE score. Conclusions: Most family caregivers of elderly patients with spinal tumours have a considerable caregiver burden. Interventions based on social support and self-efficacy can help reduce caregiver burden.

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“…7 In a multi-institutional prospective study of 969 patients that underwent lumbar spine surgery, Adogwa et al 6 demonstrated that patient-centered measures of surgical effectiveness obtained at 12 months adequately predict long-term (24-month) outcomes after lumbar spine surgery. Similarly, in a retrospective study examining 40 patients undergoing surgical resection of intradural extramedullary spinal tumors, Zuckerman et al 23 observed that both postoperative 3- and 12-month PROs were improved by the minimum clinically importance difference criteria. In another ambispective study examining 63 611 patients undergoing breast reduction surgery, Cohen et al 24 observed no significant difference in patient reported outcomes measures 3 and 12 months after surgery, suggesting that 3-month measures of surgical effectiveness accurately may predict 12-month PRO scores.…”

Section: Discussionmentioning

confidence: 92%

Immediate Postoperative Pain Scores Predict Neck Pain Profile up to 1 Year Following Anterior Cervical Discectomy and Fusion

Adogwa

Elsamadicy

Vuong

et al. 2017

Global Spine Journal

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Study Design:Retrospective cohort review.Objective:To assess whether immediate postoperative neck pain scores accurately predict 12-month visual analog scale–neck pain (VAS-NP) outcomes following Anterior Cervical Discectomy and Fusion surgery (ACDF).Methods:This was a retrospective study of 82 patients undergoing elective ACDF surgery at a major academic medical center. Patient reported outcomes measures VAS-NP scores were recorded on the first postoperative day, then at 6-weeks, 3, 6, and 12-months after surgery. Multivariate correlation and logistic regression methods were utilized to determine whether immediate postoperative VAS-NP score accurately predicted 1-year patient reported VAS-NP Scores.Results:Overall, 46.3% male, 25.6% were smokers, and the mean age and body mass index (BMI) were 53.7 years and 28.28 kg/m2, respectively. There were significant correlations between immediate postoperative pain scores and neck pain scores at 6 weeks VAS-NP (P = .0015), 6 months VAS-NP (P = .0333), and 12 months VAS-NP (P = .0247) after surgery. Furthermore, immediate postoperative pain score is an independent predictor of 6 weeks, 6 months, and 1 year VAS-NP scores.Conclusion:Our study suggests that immediate postoperative patient reported neck pain scores accurately predicts and correlates with 12-month VAS-NP scores after an ACDF procedure. Patients with high neck pain scores after surgery are more likely to report persistent neck pain 12 months after index surgery.

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Surgical Resection of Intradural Extramedullary Spinal Tumors: Patient-Reported Outcomes and Minimum Clinically Important Difference

Cited by 8 publications

References 0 publications

Healthcare Resource Utilization and Patient-Reported Outcomes Following Elective Surgery for Intradural Extramedullary Spinal Tumors

Healthcare Resource Utilization and Patient-Reported Outcomes Following Elective Surgery for Intradural Extramedullary Spinal Tumors

Factors related to the burden of family caregivers of elderly patients with spinal Tumours in Northwest China

Immediate Postoperative Pain Scores Predict Neck Pain Profile up to 1 Year Following Anterior Cervical Discectomy and Fusion

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