Skip to main content

Advertisement

SpringerLink
Log in

Recovery ratios and minimum clinically important difference for clinical outcomes in workers’ compensation recipients undergoing MIS-TLIF versus ALIF

  • Original Article - Spine - Other
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

There is a scarcity of literature that examines clinical outcomes through patient-reported outcomes (PROs), minimum clinically important difference (MCID), and recovery ratios (RR) for workers’ compensation (WC) recipients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) versus anterior lumbar interbody fusion (ALIF).

Methods

WC claimants undergoing MIS-TLIF versus ALIF were propensity score matched to account for demographic differences. Demographics, perioperative characteristics, and PROs were collected. PROs of Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF), 12-Item Short Form Physical Composite Score (SF-12 PCS), Visual Analog Scale (VAS) back, VAS leg, and Oswestry Disability Index (ODI) were collected at preoperative and postoperative time points. MCID achievement was determined through comparison to values in literature. RR was calculated as the difference between postoperative and preoperative PROs over potential improvement. Comparison between surgical techniques was through non-parametric inferential statistics.

Results

Eighty-four WC claimants, with 50 patients undergoing MIS-TLIF, were identified after propensity score matching. ALIF patients had higher estimated blood loss. MIS-TLIF patients had higher postoperative day (POD) 0 VAS pain and POD 0 + 1 narcotic consumption. Patients undergoing either MIS-TLIF or ALIF reported significant improvement in pain and disability. ALIF patients reported significant improvement in physical function. ALIF patients reported superior 1-year PROMIS-PF, 6-week SF-12 PCS, 6-month VAS back, and 12-week VAS leg. No significant differences in MCID achievement rates were noted between cohorts. ALIF patients had higher RR in 6-week and 1-year PROMIS-PF and 6-week SF-12 PCS.

Conclusion

Workers’ compensation claimants undergoing either MIS-TLIF or ALIF reported significant improvement in pain and disability. ALIF patients reported superior postoperative physical function and pain. ALIF patients had higher recovery ratios in physical function. Workers’ compensation claimants undergoing ALIF may experience greater physical function recovery and superior clinical outcomes in physical function and pain.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data Availability

The data that support the findings of this study were generated at Rush University Medical Center and are available upon reasonable request from the corresponding author KS.

Abbreviations

ALIF:

Anterior lumbar interbody fusion

ASA:

American Society of Anesthesiologists

BMI:

Body mass index

CCI:

Charlson Comorbidity Index

HNP:

Herniated nucleus pulposus

IRB:

Institutional Review Board

MCID:

Minimum clinically important difference

MIS-TLIF:

Minimally invasive transforaminal lumbar interbody

ODI:

Oswestry Disability Index

PLIF:

Posterior lumbar interbody fusion

POD:

Postoperative day

PROMIS-PF:

Patient-Reported Outcomes Measurement Information System Physical Function

PROs:

Patient-reported outcomes

RR:

Recovery ratio

SD:

Standard deviations

SF-12 PCS:

12-Item Short Form Physical Component Score

TLIF:

Transforaminal lumbar interbody fusion

VAS:

Visual Analog Scale

WC:

Workers’ compensation

References

  1. Brodke DS, Goz V, Voss MW, Lawrence BD, Spiker WR, Hung M (2017) PROMIS PF CAT outperforms the ODI and SF-36 Physical Function Domain in spine patients. Spine (Phila Pa 1976) 42(12):921–929

    Article  PubMed  Google Scholar 

  2. Chen DA, Vaishnav AS, Louie PK et al (2020) Patient reported outcomes in patients who stop following up: Are they doing better or worse than the patients that come back? Spine (Phila Pa 1976) 45(20):1435–1442

    Article  PubMed  Google Scholar 

  3. Costa MA, Silva PS, Vaz R, Pereira P (2021) Correlation between clinical outcomes and spinopelvic parameters in patients with lumbar stenosis undergoing decompression surgery. Eur Spine J 30(4):928–935

    Article  PubMed  Google Scholar 

  4. Fujibayashi S, Neo M, Takemoto M, Ota M, Nakamura T (2010) Paraspinal-approach transforaminal lumbar interbody fusion for the treatment of lumbar foraminal stenosis. J Neurosurg Spine 13(4):500–508

    Article  PubMed  Google Scholar 

  5. Haws BE, Khechen B, Guntin JA, Cardinal KL, Bohl DD, Singh K (2018) Validity of PROMIS in minimally invasive transforaminal lumbar interbody fusion: a preliminary evaluation. J Neurosurg Spine 29(1):28–33

    Article  PubMed  Google Scholar 

  6. Hsieh PC, Koski TR, O’Shaughnessy BA et al (2007) Anterior lumbar interbody fusion in comparison with transforaminal lumbar interbody fusion: implications for the restoration of foraminal height, local disc angle, lumbar lordosis, and sagittal balance. J Neurosurg Spine 7(4):379–386

    Article  PubMed  Google Scholar 

  7. Inamasu J, Guiot BH (2006) Vascular injury and complication in neurosurgical spine surgery. Acta Neurochir (Wien) 148(4):375–387

    Article  CAS  PubMed  Google Scholar 

  8. Jenkins NW, Parrish JM, Cha EDK et al (2020) Validation of PROMIS physical function in MIS TLIF: 2-year follow-up. Spine 45(22):E1516–E1522

    Article  PubMed  Google Scholar 

  9. Jiang SD, Chen JW, Jiang LS (2012) Which procedure is better for lumbar interbody fusion: anterior lumbar interbody fusion or transforaminal lumbar interbody fusion? Arch Orthop Trauma Surg 132(9):1259–1266

    Article  PubMed  Google Scholar 

  10. Kim JS, Lee KY, Lee SH, Lee HY (2010) Which lumbar interbody fusion technique is better in terms of level for the treatment of unstable isthmic spondylolisthesis?: clinical article. J Neurosurg Spine 12(2):171–177

    Article  PubMed  Google Scholar 

  11. Kim YH, Ha KY, Rhyu KW et al (2020) Lumbar interbody fusion: techniques, pearls and pitfalls. Asian Spine J 14(5):730–741

    Article  PubMed  PubMed Central  Google Scholar 

  12. Kumar A, Merrill RK, Overley SC et al (2019) Radiation exposure in minimally invasive transforaminal lumbar interbody fusion: the effect of the learning curve. Int J Spine Surg 13(1):39–45

    Article  PubMed  PubMed Central  Google Scholar 

  13. Middleton K, Fish DE (2009) Lumbar spondylosis: clinical presentation and treatment approaches. Curr Rev Musculoskelet Med 2(2):94–104

    Article  PubMed  PubMed Central  Google Scholar 

  14. Mobbs RJ, Phan K, Malham G, Seex K, Rao PJ (2015) Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP LLIF and ALIF. J Spine Surg 1(1):2–18

    PubMed  PubMed Central  Google Scholar 

  15. Patel DV, Bawa MS, Haws BE et al (2019) PROMIS physical function for prediction of postoperative pain, narcotics consumption, and patient-reported outcomes following minimally invasive transforaminal lumbar interbody fusion. J Neurosurg Spine 30(4):476–482

    Article  Google Scholar 

  16. Sim EM, Claydon MH, Parker RM, Malham GM (2015) Brief intraoperative heparinization and blood loss in anterior lumbar spine surgery. J Neurosurg Spine 23(3):309–313

    Article  PubMed  Google Scholar 

  17. Simon J, Longis PM, Passuti N (2017) Correlation between radiographic parameters and functional scores in degenerative lumbar and thoracolumbar scoliosis. Orthop Traumatol Surg Res 103(2):285–290

    Article  CAS  PubMed  Google Scholar 

  18. Russo F, De Salvatore S, Ambrosio L et al (2021) Does workers’ compensation status affect outcomes after lumbar spine surgery? A systematic review and meta-analysis. Int J Environ Res Public Health 18(11):6165

  19. Nie JW, Hartman TJ, Pawlowski H, et al (2022) Impact of ambulatory setting for workers’ compensation patients undergoing one-level minimally invasive transforaminal lumbar interbody fusion and review of the literature. World Neurosurg. Published online August 7. https://doi.org/10.1016/j.wneu.2022.07.136

Download references

Author information

Authors and Affiliations

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

    James W. Nie, Timothy J. Hartman, Omolabake O. Oyetayo, Keith R. MacGregor, Eileen Zheng, Dustin H. Massel & Kern Singh

Authors
  1. James W. Nie
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Timothy J. Hartman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Omolabake O. Oyetayo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Keith R. MacGregor
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eileen Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dustin H. Massel
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kern Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

James W. Nie: conceptualization, methodology, visualization, formal analysis, software, investigation, writing—original draft, and writing—review and editing. Timothy J. Hartman: conceptualization, methodology, visualization, formal analysis, software, investigation, writing—original draft, and writing—review and editing. Omolabake O. Oyetayo: project administration, data curation, investigation, and writing—review and editing. Keith R. MacGregor: project administration, data curation, investigation, and writing—review and editing. Eileen Zheng: project administration, data curation, investigation, and writing—review and editing. Dustin H. Massel: conceptualization, methodology, visualization, and writing—review and editing. Kern Singh: conceptualization, methodology, supervision, resources, investigation, and writing—review and editing.

Corresponding author

Correspondence to Kern Singh.

Ethics declarations

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Institutional Review Board (IRB) of Rush University Medical Center (ORA #14051301).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

Kern Singh, MD receives royalties from Zimmer Biomet, Stryker, RTI Surgical, Lippincott Williams and Wilkins, Thieme, Jaypee Publishing, and Slack Publishing. Kern Singh, MD owns stock in Avaz Surgical LLC and Vital 5 LLC. Kern Singh, MD holds a consulting position with Zimmer Biomet and K2M. Kern Singh, MD holds board membership with Vital 5 LLC. Kern Singh, MD is on the editorial board of Contemporary Spine Surgery. Kern Singh, MD received a research grant from the Cervical Spine Research Society. Kern Singh, MD holds board membership with TDi LLC and Minimally Invasive Spine Study Group and receives no compensation as a board member. Kern Singh, MD is on the editorial board of Orthopedics Today and Vertebral Columns and receives no compensation as a member of the editorial board. Kern Singh, MD is on the board of directors of the Cervical Spine Research Society, International Society for the Advancements of Spine Surgery, and American Academy of Orthopaedic Surgeons and receives no compensation as a member of the board of directors.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Spine - Other

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nie, J.W., Hartman, T.J., Oyetayo, O.O. et al. Recovery ratios and minimum clinically important difference for clinical outcomes in workers’ compensation recipients undergoing MIS-TLIF versus ALIF. Acta Neurochir 165, 315–323 (2023). https://doi.org/10.1007/s00701-022-05468-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-022-05468-4

Keywords

Search

Navigation