Do Six-Week Postoperative Patient-Reported Outcomes Predict Long-Term Clinical Outcomes Following Lumbar Decompression?

BACKGROUND: Little research has been done evaluating the prognostic value of short-term postoperative patient-reported outcomes (PROs) on long-term PROs following lumbar decompression (LD).

OBJECTIVE: To evaluate the prognostic value of short-term PROs on long-term PROs through two years following LD.

METHODS: A single spine surgeon database was retrospectively queried for patients undergoing primary LD and had six-week postoperative PROs reported. Demographics, perioperative traits, preoperative, six-month, one-year and two-year PROs were gathered. PROs included Visual Analog Scale (VAS) Back, VAS-Leg, Patient-Reported Outcome Measure Information System-Physical Function (PROMIS-PF), and Oswestry Disability Index (ODI). Two-step multivariate linear regression was performed to determine predictive value of six-week PROs (PRO-6W) on six-month, one-year, and two-year PROs.

RESULTS: Two hundred seventy-seven patients were included. Six-week ODI, VAS-L, and PHQ-9 are all positive predictors for their respective outcomes at six-months. Additionally, six-week PROMIS-PF was a negative predictor of six-month PHQ-9. Six-week PROMIS-PF positively predicted PROMIS-PF through one-year, while PHQ-9 was a positive predictor of PHQ-9 at one and two years postoperatively.

CONCLUSION: Six-week postoperative PROs are predictive of the same outcomes at six months, PROMIS-PF is predictive through one-year, and PHQ-9 is predictive through two years. Determining the predictive value of early postoperative PROs can be helpful in understanding the likely postoperative trajectory following lumbar decompression and informing patient expectations.