Association between the appropriateness of surgery, according to appropriate use criteria, and patient-rated outcomes after surgery for lumbar degenerative spondylolisthesis.

Details

Serval ID
serval:BIB_31987673862A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Association between the appropriateness of surgery, according to appropriate use criteria, and patient-rated outcomes after surgery for lumbar degenerative spondylolisthesis.
Journal
European spine journal
Author(s)
Mannion A.F., Mariaux F., Pittet V., Steiger F., Aepli M., Fekete T.F., Jeszenszky D., O'Riordan D., Porchet F.
ISSN
1432-0932 (Electronic)
ISSN-L
0940-6719
Publication state
Published
Issued date
04/2021
Peer-reviewed
Oui
Volume
30
Number
4
Pages
907-917
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Treatment failures in spine surgery are often attributable to poor patient selection and the application of inappropriate treatment. We used published appropriate use criteria (AUC) to evaluate the appropriateness of surgery in a large group of patients operated for lumbar degenerative spondylolisthesis (LDS) and to evaluate its association with outcome.
This was a retrospective analysis of prospectively collected outcome data from patients operated in our Spine Centre, 2005-2012. Appropriateness of surgery was judged based on the AUC. Patients had completed the multidimensional Core Outcome Measures Index (COMI) before surgery and at 3 months' and 1, 2 and 5 years' follow-up (FU).
In total, 448 patients (69.8 ± 9.6 years; 323 (72%) women) were eligible for inclusion and the AUC could be applied in 393 (88%) of these. Surgery was considered appropriate (A) in 234 (59%) of the patients, uncertain/equivocal (U) in 90 (23%) and inappropriate (I) in 69 (18%). A/U patients had significantly (p < 0.05) greater improvements in COMI than I patients at each FU time point. The minimal clinically important change (MCIC) score for COMI was reached by 82% A, 76% U and 54% I patients at 1-year FU (p < 0.001, I vs A and U); the odds of achieving MCIC were 3-4 times greater in A/U patients than in I patients.
The results suggest a relationship between appropriateness of surgery for LDS and the improvements in COMI score after surgery. The findings require confirmation in prospective studies that also include a control group of non-operated patients.
Keywords
Female, Humans, Lumbosacral Region, Outcome Assessment, Health Care, Prospective Studies, Retrospective Studies, Spondylolisthesis, Appropriate use criteria, Degenerative spondylolisthesis, Outcome
Pubmed
Web of science
Create date
22/02/2021 12:33
Last modification date
20/08/2022 6:40
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