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Validating the VR-12 Physical Function Instrument After Anterior Cervical Discectomy and Fusion with SF-12, PROMIS, and NDI

  • Original Article
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HSS Journal ®

Abstract

Background

Development and validation of Veterans RAND 12-item (VR-12) physical component survey (PCS) has been established among civilian and veteran populations but it has not been examined among anterior cervical discectomy and fusion (ACDF) patients.

Purposes/Questions

We sought to validate legacy patient-reported outcome measures (PROMs) with VR-12 PCS among patients undergoing ACDF procedures.

Methods

A prospectively collected surgical registry was retrospectively evaluated for elective single or multi-level ACDFs performed for degenerative spinal pathologies from January 2014 to August 2019. Exclusion criteria included missing pre-operative surveys and surgery for trauma, metastasis, or infection. Demographic variables, baseline pathologies, and peri-operative variables were collected. A paired t test evaluated the change from the pre-operative score to each post-operative timepoint for VR-12 PCS, the 12-item Short-Form Survey (SF-12) PCS, Patient-Reported Outcomes Measurement Information System physical function (PROMIS-PF), and Neck Disability Index (NDI). Minimal clinically important difference (MCID) achievement was calculated at each timepoint. Correlation was evaluated with a Pearson’s correlation coefficient and time-independent partial correlation.

Results

Of the 202 patients who underwent ACDF, 41.1% were female and the average age was 49.5 years. All PROMs had statistically significantly increased from baseline when compared with post-operative timepoints (12 weeks, 6 months, 1 year, and 2 years). MCID achievement rates increased through 2 years. All timepoints revealed strong VR-12 PCS correlations with SF-12 PCS, PROMIS-PF, and NDI scores.

Conclusion

VR-12 PCS was strongly correlated with the well-validated SF-12 PCS and NDI metrics as well as with the more recent PROMIS-PF. All PROMs demonstrated statistically significant improvement in patients post-operatively. VR-12 PCS is a valid measure of physical function among patients undergoing ACDF.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St. Suite #300, Chicago, IL, 60612, USA

    Nathaniel W. Jenkins MS, James M. Parrish MPH, Michael T. Nolte MD, Nadia M. Hrynewycz BS, Thomas S. Brundage BS & Kern Singh MD

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  1. Nathaniel W. Jenkins MS
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  2. James M. Parrish MPH
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  3. Michael T. Nolte MD
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Correspondence to Kern Singh MD.

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Conflict of Interest

Nathaniel W. Jenkins, MS, James M. Parrish, MPH, Michael T. Nolte, MD, Nadia M. Hrynewycz, BS, and Thomas S. Brundage, BS, declare that they have no conflicts of interest. Kern Singh, MD, reports personal fees and royalties from Zimmer Biomet, royalties from Stryker, RTI Surgical, and Lippincott Williams and Wilkins, stock ownership from Avaz Surgical LLC, stock ownership and board membership from Vital 5 LLC, personal fees from K2M, non-financial support and board membership from TDi LLC, non-financial support from Minimally Invasive Spine Study Group, Contemporary Spine Surgery, Orthopedics Today, and Vertebral Columns, and grants from Cervical Spine Research Society, outside the submitted work.

Human/Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2013.

Informed Consent

Informed consent was waived] from all patients for being included in this study.

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Level of Evidence: Level III: Retrospective Cohort Study

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Jenkins, N.W., Parrish, J.M., Nolte, M.T. et al. Validating the VR-12 Physical Function Instrument After Anterior Cervical Discectomy and Fusion with SF-12, PROMIS, and NDI. HSS Jrnl 16 (Suppl 2), 443–451 (2020). https://doi.org/10.1007/s11420-020-09817-w

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  • DOI: https://doi.org/10.1007/s11420-020-09817-w

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