Authors: Avani Vaishnav; Catherine Gang, MPH; Steven McAnany, MD; Sravisht Iyer, MD; Todd Albert, MD; Sheeraz Qureshi, MD, MBA (New York, NY)
Introduction:As the focus in spine surgery shifts from radiographic to patient-centric outcomes, patient-reported outcomes measures(PROMs) are becoming important. Thus, it is vital to evaluate new outcome measures.
Purpose:To evaluate the correlation between Oswestry Disability Index(ODI), Patient Reported Outcome Measurement Information System Physical Function(PROMIS-PF) and Short Form-12 Physical Health Score(SF-12 PHS) in minimally invasive lumbar surgery.
Methods:PROMs collected pre-operatively and 2 weeks, 6 weeks, 3 months, 6 months and 1 year post-operatively of patients undergoing lumbar surgery were analyzed using Pearson product-moment correlation.
Of the 292 patients included, 158 underwent lumbar decompression and 134 underwent lumbar fusions. ODI decreased from 40.84+19.23 pre-operatively to 16.01+12.84 at 1 year. Similarly, PROMIS-PF and SF-12 PHS improved from 35.51+7.92 to 47.78+11.55 and 32.37+8.38 to 43.35+10.43, respectively.
A statistically significant, negative correlation was seen between ODI and PROMIS-PF at all time-points, which was strong pre-operatively(r=-0.673,n=256,p<0.0001) and at 2 weeks(r=-0.715,n=228,p<0.0001), 6 weeks(r=-0.779,n=190,p<0.0001), 3 months(r=-0.732,n=130,p<0.0001) and 6 months(r=-0.685,n=80,p<0.0001); and moderate at 1 year(r=-0.517,n=22,p=0.010).
A statistically significant, negative correlation was also seen between SF-12 PHS and ODI at all time-points, which was weak pre-operatively(r=-0.384,n=287,p<0.0001), but strong post-operatively(2 weeks:p=-0.625,n=272,p<0.0001; 6 weeks:r=-0.686,n=230,p<0.0001; 3 months:r=-0.761,n=171,p<0.0001; 6 months:r=-0.789,n=108,p<0.0001; 1 year:r=-0.740,n=31,p<0.0001).
There was a statistically significant positive correlation between SF-12 PHS and PROMIS-PF at all time-points, which was weak pre-operatively(r=0.393,n=255,p<0.0001); strong at 2 weeks(r=0.630,n=224,p<0.0001), 6 weeks(r=0.676,n=190,p<0.0001), 3 months(r=0.781,n=128,p<0.0001) and 6 months(r=0.718,n=78,p<0.0001); and moderate at 1 year(r=0.548,n=22,p0.008).
While ODI and SF-12 have been used for several years, PROMIS is a new outcome measure. Our results show that PROMIS-PF correlates strongly with ODI and SF-12 PHS, thus indicating that PROMIS may be a good surrogate for these legacy measures, as it not only captures disease-specific disability but also reflects the impact on overall physical health. Larger studies are warranted to evaluate the utility and value of this outcome measure in common lumbar spinal conditions.