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

dc.contributor.author

Dru, Alexander

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Johnson, Sarah E

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Linzey, Joseph R

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Foley, Kevin T

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Digiorgio, Anthony

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Alan, Nima

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Coric, Domagoj

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Potts, Eric A

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Bisson, Erica F

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Knightly, John J

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Fu, Kai-Ming

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Shaffrey, Mark E

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Weaver, Jason

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Bydon, Mohamad

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Chou, Dean

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Meyer, Scott A

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Asher, Anthony L

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Shaffrey, Christopher I

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Slotkin, Jonathan R

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Wang, Michael Y

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Haid, Regis W

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Glassman, Steven D

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Virk, Michael S

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Mummaneni, Praveen V

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Park, Paul

dc.date.accessioned

2024-09-12T17:54:07Z

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2024-09-12T17:54:07Z

dc.date.issued

2024-08

dc.description.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.
dc.identifier.issn

1547-5654

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1547-5646

dc.identifier.uri

https://hdl.handle.net/10161/31479

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eng

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Journal of Neurosurgery Publishing Group (JNSPG)

dc.relation.ispartof

Journal of neurosurgery. Spine

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10.3171/2024.5.spine24227

dc.rights.uri

https://creativecommons.org/licenses/by-nc/4.0

dc.subject

Quality Outcomes Database

dc.subject

degenerative

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patient-reported outcomes

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spine surgery

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spondylolisthesis

dc.title

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

dc.type

Journal article

duke.contributor.orcid

Shaffrey, Christopher I|0000-0001-9760-8386

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1

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8

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Duke

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School of Medicine

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Clinical Science Departments

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Orthopaedic Surgery

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Neurosurgery

pubs.publication-status

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