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Preoperative patient activation is predictive of improvements in patient-reported outcomes following minimally invasive lumbar decompression

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Abstract

Purpose

To determine whether there is an association between preoperative 10-Item Patient Activation Measure (PAM-10) scores and clinical outcomes following MIS LD.

Methods

Patients undergoing a primary MIS LD were retrospectively reviewed and stratified according to their preoperative PAM-10 scores: “low PAM,” “moderate PAM,” and “high PAM.” Preoperative PAM score cohorts were tested for improvements in Oswestry Disability Index (ODI), 12-Item Short-Form Physical Component Score (SF-12 PCS), and Visual Analog Scale (VAS) back and leg pain using multivariate linear regression.

Results

Eighty-nine patients were included: 29 had a low PAM score, 32 had a moderate PAM score, and 28 had a high PAM score. Cohorts experienced similar preoperative VAS back pain, VAS leg pain, ODI, and SF-12 PCS. Patients with low PAM scores experienced a trend of higher pain scores throughout 6 months with VAS back pain being significant at 3 months and VAS leg pain being significant at 6-week and 3-month follow-up. Patients with lower PAM scores experienced a worse improvement in ODI at 6-week, 3-month, and 6-month timepoints. Lastly, patients with lower PAM scores demonstrated less improvement in SF-12 PCS at 3-month and 6-month follow-up.

Conclusions

Lower preoperative PAM scores were associated with worse improvement in clinical outcomes following MIS LD. Patients with lower PAM scores had diminished improvement in long-term patient-reported outcomes including ODI, SF-12, and VAS back and leg pain. Our investigation suggests that preoperative PAM assessments may be an effective tool to predict postoperative outcomes following MIS LD.

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Funding

No funds were received in support of this work. No benefits in any form have been or will be received from any commercial party related directly or indirectly to the subject of this manuscript.

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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, James M. Parrish, Shruthi Mohan, Cara E. Geoghegan, Caroline N. Jadczak, Nadia M. Hrynewycz & Kern Singh

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  1. Nathaniel W. Jenkins
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Correspondence to Kern Singh.

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Jenkins, N.W., Parrish, J.M., Mohan, S. et al. Preoperative patient activation is predictive of improvements in patient-reported outcomes following minimally invasive lumbar decompression. Eur Spine J 29, 2222–2230 (2020). https://doi.org/10.1007/s00586-020-06512-6

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  • DOI: https://doi.org/10.1007/s00586-020-06512-6

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