A 3-Year Study Investigating the Utility of Patient-Reported Outcomes Measurement Information System-29 for Long-Term Follow-Up in Adult Spinal Deformity

Faraaz Azam; Ishav Shukla; William H Hicks; Soummitra Anand; Kailee Furtado; Parker D Smith; Kristen Hall; Omar S Akbik; Carlos A Bagley

doi:10.1016/j.wneu.2024.03.165

A 3-Year Study Investigating the Utility of Patient-Reported Outcomes Measurement Information System-29 for Long-Term Follow-Up in Adult Spinal Deformity

World Neurosurg. 2024 Apr 5:S1878-8750(24)00551-5. doi: 10.1016/j.wneu.2024.03.165. Online ahead of print.

Authors

Faraaz Azam¹, Ishav Shukla¹, William H Hicks¹, Soummitra Anand¹, Kailee Furtado¹, Parker D Smith¹, Kristen Hall¹, Omar S Akbik², Carlos A Bagley³

Affiliations

¹ Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
² Department of Neurological Surgery, CHI Health, Omaha, NE, USA; Department of Neurological Surgery, Saint Luke's Neurological & Spine Surgery, Kansas City, MO, USA.
³ Department of Neurological Surgery, Saint Luke's Neurological & Spine Surgery, Kansas City, MO, USA. Electronic address: cabagley@saint-lukes.org.

PMID: 38583560
DOI: 10.1016/j.wneu.2024.03.165

Abstract

Background: Adult spinal deformity (ASD) significantly impacts the quality of life due to three-dimensional spinal abnormalities. Patient-reported outcome measures, such as the Patient-Reported Outcomes Measurement Information System (PROMIS-29), play a crucial role in assessing postoperative outcomes. This study aims to investigate trends in PROMIS-29 scores over 36 months in patients undergoing long-segment thoracolumbar fusion for ASD and provide insights into its long-term utility.

Methods: A retrospective study including 163 ASD patients undergoing long-segment thoracolumbar fusion was conducted. PROMIS-29 scores were collected at baseline and at postoperative (0-), 3-, 6-, 12-, 18-, 24-, 30-, and 36-month follow-ups. Statistical analyses was performed to assess significant score changes from baseline and in consecutive recordings.

Results: Significant improvements in all PROMIS-29 categories were observed at 36 months, with the greatest changes in pain intensity (-35.19%, P < 0.001), physical function (+29.13%, P < 0.001), and pain interference (-28.8%, P < 0.001). Between the 0 and 3 month mark, the greatest significant changes were recorded in pain intensity (-26.5%, P < 0.001), physical function (+24.3%, P < 0.001), and anxiety (-16.9%, P < 0.018). However, scores plateaued after the 3-month mark, with zero categories showing significant changes with subsequent consecutive recordings.

Conclusions: PROMIS-29 scores demonstrated notable improvements in ASD patients particularly in pain intensity, pain interference, and physical function. However, scores plateaued beyond the 3-month mark, suggesting PROMIS-29's limited sensitivity to nuanced changes in long-term patient recovery. Future investigations exploring optimal combinations of patient reported outcome measures for comprehensive short- and long-term outcome assessments in ASD surgery would be beneficial.

Keywords: Adult spinal deformity; Long-segment thoracolumbar fusion; PROMIS-29; Patient reported outcome measures.