Comparative effectiveness research across two spine registries.
Details
Serval ID
serval:BIB_3206A87BB467
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Comparative effectiveness research across two spine registries.
Journal
European Spine Journal
Working group(s)
SWISSspine, Spine Tango Registry groups
Contributor(s)
Bärlocher C., Sgier F., Etter C., Hausmann O., Schwarzenbach O., Huber J., Aebi M., Heini P., Berlemann U., Markwalder T., Otten P., Schaeren S., Maestretti GL., Schizas C., Waelchli B., Porchet F., Baur M., Kast E., Seidel U., Lutz T., Grob D., Jeanneret B., Kroeber M., Min K., Hasdemir M., Lattig F., Morard M., Renella R., Richter H., Van Domelen K., Wernli FO., Binggeli R., Stoll TM., Marchesi D., Tessitore E., Vernet O., Faundez A., Favre J., Ramadan A., Selz T., Boos N., Cathrein P., Forster T., Heilbronner R., Kleinstueck F., Martinez R., Rischke B.
ISSN
1432-0932 (Electronic)
ISSN-L
0940-6719
Publication state
Published
Issued date
2012
Peer-reviewed
Oui
Volume
21
Number
8
Pages
1640-1647
Language
english
Notes
Publication types: Comparative Study ; Journal Article
Abstract
BACKGROUND: Comparative effectiveness research in spine surgery is still a rarity. In this study, pain alleviation and quality of life (QoL) improvement after lumbar total disc arthroplasty (TDA) and anterior lumbar interbody fusion (ALIF) were anonymously compared by surgeon and implant.
METHODS: A total of 534 monosegmental TDAs from the SWISSspine registry were analyzed. Mean age was 42 years (19-65 years), 59% were females. Fifty cases with ALIF were documented in the international Spine Tango registry and used as concurrent comparator group for the pain analysis. Mean age was 46 years (21-69 years), 78% were females. The average follow-up time in both samples was 1 year. Comparison of back/leg pain alleviation and QoL improvement was performed. Unadjusted and adjusted probabilities for achievement of minimum clinically relevant improvements of 18 VAS points or 0.25 EQ-5D points were calculated for each surgeon.
RESULTS: Mean preoperative back pain decreased from 69 to 30 points at 1 year (ØΔ 39pts) after TDA, and from 66 to 27 points after ALIF (ØΔ 39pts). Mean preoperative QoL improved from 0.34 to 0.74 points at 1 year (ØΔ 0.40pts). There were surgeons with better patient selection, indicated by lower adjusted probabilities reflecting worsening of outcomes if they had treated an average patient sample. ALIF had similar pain alleviation than TDA.
CONCLUSIONS: Pain alleviation after TDA and ALIF was similar. Differences in surgeon's patient selection based on pain and QoL were revealed. Some surgeons seem to miss the full therapeutic potential of TDA by selecting patients with lower symptom severity.
METHODS: A total of 534 monosegmental TDAs from the SWISSspine registry were analyzed. Mean age was 42 years (19-65 years), 59% were females. Fifty cases with ALIF were documented in the international Spine Tango registry and used as concurrent comparator group for the pain analysis. Mean age was 46 years (21-69 years), 78% were females. The average follow-up time in both samples was 1 year. Comparison of back/leg pain alleviation and QoL improvement was performed. Unadjusted and adjusted probabilities for achievement of minimum clinically relevant improvements of 18 VAS points or 0.25 EQ-5D points were calculated for each surgeon.
RESULTS: Mean preoperative back pain decreased from 69 to 30 points at 1 year (ØΔ 39pts) after TDA, and from 66 to 27 points after ALIF (ØΔ 39pts). Mean preoperative QoL improved from 0.34 to 0.74 points at 1 year (ØΔ 0.40pts). There were surgeons with better patient selection, indicated by lower adjusted probabilities reflecting worsening of outcomes if they had treated an average patient sample. ALIF had similar pain alleviation than TDA.
CONCLUSIONS: Pain alleviation after TDA and ALIF was similar. Differences in surgeon's patient selection based on pain and QoL were revealed. Some surgeons seem to miss the full therapeutic potential of TDA by selecting patients with lower symptom severity.
Pubmed
Web of science
Create date
25/01/2013 15:17
Last modification date
20/08/2019 13:17
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