Quantifying Satisfaction of Degenerative Lumbar Spinal Stenosis Patients in Post-lateral Lumbar Interbody Fusion Surgery: Establishing Critical JOABPEQ Cutoff Scores

Akihiko Hiyama; Daisuke Sakai; Hiroyuki Katoh; Masato Sato; Masahiko Watanabe

doi:10.1016/j.wneu.2024.03.159

Quantifying Satisfaction of Degenerative Lumbar Spinal Stenosis Patients in Post-lateral Lumbar Interbody Fusion Surgery: Establishing Critical JOABPEQ Cutoff Scores

World Neurosurg. 2024 Apr 3:S1878-8750(24)00546-1. doi: 10.1016/j.wneu.2024.03.159. Online ahead of print.

Authors

Akihiko Hiyama¹, Daisuke Sakai², Hiroyuki Katoh², Masato Sato², Masahiko Watanabe²

Affiliations

¹ Department of Orthopaedic Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan. Electronic address: a.hiyama@tokai-u.jp.
² Department of Orthopaedic Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan.

PMID: 38580092
DOI: 10.1016/j.wneu.2024.03.159

Abstract

Objective: This retrospective study aimed to determine the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) cutoff scores for assessing patient satisfaction postlateral lumbar interbody fusion (LLIF) in degenerative lumbar spinal stenosis (DLSS) patients.

Methods: Analyzing 136 DLSS patients (83 males, 53 females), the study evaluated demographics, pain (Numeric Rating Scale), and JOABPEQ outcomes (low back pain, lumbar function, walking ability, social life, mental health). Patient satisfaction was surveyed, and based on their responses, patients were categorized into "Beneficial" and "Nonbeneficial" groups. Statistical analysis encompassed the Kolmogorov-Smirnov test, t-tests, Mann-Whitney U test, and Receiver Operating Characteristic (ROC) curve analysis for JOABPEQ cutoff determination.

Results: Postoperative improvements in JOABPEQ scores, especially in walking ability, social life function, and mental health, were significant. Pain intensity, assessed using the Numeric Rating Scale, also showed notable reductions. The Δ walking ability cutoff was set at 25.00, indicating substantial mobility improvement. This domain's area under the curve (AUC) was 0.815 (95% CI: 0.726-0.903), demonstrating high effectiveness in assessing patient satisfaction postsurgery. The study also found no significant differences in complication rates between groups for conditions like transient motor weakness, thigh pain/numbness, and revision surgery.

Conclusions: This study underscores the value of patient-centered outcomes in evaluating LLIF surgery success for DLSS. The identified JOABPEQ cutoff values provide a quantitative tool for assessing patient satisfaction, emphasizing the necessity of comprehensive postoperative evaluations beyond traditional clinical metrics for improved patient care and life quality.

Keywords: Degenerative lumbar spinal stenosis; Japanese Orthopedic Association Back Pain Evaluation Questionnaire; Lateral lumbar interbody fusion; Patient Satisfaction; ROC Curve Analysis; Surgical outcomes.