Predictors of patient satisfaction after surgery for grade 1 degenerative spondylolisthesis: a 5-year analysis of the Quality Outcomes Database.

IF 2.9 2区 医学 Q2 CLINICAL NEUROLOGY Journal of neurosurgery. Spine Pub Date : 2024-08-30 Print Date: 2024-11-01 DOI:10.3171/2024.5.SPINE24227
Alexander Dru, Sarah E Johnson, Joseph R Linzey, Kevin T Foley, Anthony Digiorgio, Nima Alan, Domagoj Coric, Eric A Potts, Erica F Bisson, John J Knightly, Kai-Ming Fu, Mark E Shaffrey, Jason Weaver, Mohamad Bydon, Dean Chou, Scott A Meyer, Anthony L Asher, Christopher I Shaffrey, Jonathan R Slotkin, Michael Y Wang, Regis W Haid, Steven D Glassman, Michael S Virk, Praveen V Mummaneni, Paul Park
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Abstract

Objective: Lumbar decompression and/or fusion surgery is a common operation for symptomatic lumbar spondylolisthesis refractory to conservative management. Multiyear follow-up of patient outcomes can be difficult to obtain but allows for identification of preoperative patient characteristics associated with durable pain relief, improved functional outcome, and higher patient satisfaction.

Methods: A query of the Quality Outcomes Database (QOD) low-grade spondylolisthesis module for patients who underwent surgery for grade 1 lumbar spondylolisthesis (from July 2014 to June 2016 at the 12 highest-enrolling sites) was used to identify patient satisfaction, as measured with the North American Spine Society (NASS) questionnaire, which uses a scale of 1-4. Patients were considered satisfied if they had a score ≤ 2. Multivariable logistic regression was performed to identify baseline demographic and clinical predictors of long-term satisfaction 5 years after surgery.

Results: Of 573 eligible patients from a cohort of 608, patient satisfaction data were available for 81.2%. Satisfaction (NASS score of 1 or 2) was reported by 389 patients (83.7%) at 5-year follow-up. Satisfied patients were predominantly White and ambulation independent and had lower baseline BMI, lower back pain levels, lower Oswestry Disability Index (ODI) scores, and greater EQ-5D index scores at baseline when compared to the unsatisfied group. No significant differences in reoperation rates between groups were reported at 5 years. On multivariate analysis, patients who were independently ambulating at baseline had greater odds of long-term satisfaction (OR 1.12, p = 0.04). Patients who had higher 5-year ODI scores (OR 0.99, p < 0.01) and were uninsured (OR 0.43, p = 0.01) were less likely to report long-term satisfaction.

Conclusions: Lumbar surgery for the treatment of grade 1 spondylolisthesis can provide lasting pain relief with high patient satisfaction. Baseline independent ambulation is associated with a higher long-term satisfaction rate after surgery. Higher ODI scores at 5-year follow-up and uninsured status are associated with lower postoperative long-term satisfaction.

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1级退行性脊椎滑脱症术后患者满意度的预测因素:质量结果数据库的5年分析。
目的:腰椎减压和/或融合手术是治疗保守治疗无效的症状性腰椎滑脱症的常见手术。对患者疗效的多年随访可能难以获得,但可以确定与疼痛持久缓解、功能疗效改善和患者满意度提高相关的术前患者特征:通过查询质量结果数据库(QOD)低级别椎体滑脱症模块中接受 1 级腰椎滑脱症手术的患者(2014 年 7 月至 2016 年 6 月,12 个注册人数最多的医疗机构),确定患者的满意度,采用北美脊柱协会(NASS)问卷进行测量,该问卷采用 1-4 级量表。如果患者的得分≤2分,则视为满意。为了确定术后5年长期满意度的基线人口统计学和临床预测因素,我们进行了多变量逻辑回归:在 608 位符合条件的患者中,有 573 位患者提供了 81.2% 的满意度数据。389名患者(83.7%)在5年随访时报告了满意度(NASS评分为1分或2分)。与不满意组相比,满意组患者主要为白人,可以独立行走,基线体重指数(BMI)较低,背痛程度较轻,Oswestry残疾指数(ODI)评分较低,EQ-5D指数评分较高。5年后,各组间的再手术率无明显差异。多变量分析显示,基线时能独立行走的患者长期满意度更高(OR 1.12,P = 0.04)。5年ODI评分较高的患者(OR 0.99,p < 0.01)和无保险的患者(OR 0.43,p = 0.01)较少报告长期满意度:结论:腰椎手术治疗1级椎体滑脱症能持久缓解疼痛,患者满意度高。基线独立行走与术后较高的长期满意度有关。随访5年时较高的ODI评分和无保险状况与较低的术后长期满意度相关。
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来源期刊
Journal of neurosurgery. Spine
Journal of neurosurgery. Spine 医学-临床神经学
CiteScore
5.10
自引率
10.70%
发文量
396
审稿时长
6 months
期刊介绍: Primarily publish original works in neurosurgery but also include studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology.
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