Patient-reported outcome measure completion in lumbar spine surgery: Rates and determinants in a multicenter registry

Introduction: Patient-reported outcome measures (PROMs) are increasingly used to aid clinical decision-making, evaluate treatment outcomes, and support quality improvement in spine care. However, to ensure valid and representative outcomes, sufficient completion rates are crucial. Research question: The objective of this study is to assess PROM completion rates in routine lumbar spine surgery care and to identify patient- and hospital-level factors associated with completion. Materials and methods: Data were obtained from patients undergoing low-complex lumbar spine surgery for degeneration, with and without instrumentation, recorded in the Spine Tango Registry. PROM completion was assessed as completion of any, baseline, or follow-up PROM, and paired baseline and follow-up PROMs. Mixed-effects logistic regression models were used to evaluate associations between PROM completion and patient characteristics (e.g. age, diagnosis, surgical procedure) and to describe hospital- and country-level variability. Additionally, an exploratory survey among participating hospitals assessed PROM collection strategies. Results: A total of 1810 patients from 5 countries were included. Overall, 67.3% of patients completed at least one PROM, 57.9% completed a baseline PROM, 53.3% completed a follow-up PROM and 44.4% completed paired baseline and follow-up PROMs. Completion rates declined with increasing follow-up duration. Age, diagnosis, and type of surgery were significantly associated with PROM completion. Substantial variability in PROM completion was observed between hospitals. Discussion and conclusion: PROM completion in routine lumbar spine surgery care remains suboptimal, particularly for long-term follow-up and paired PROMs. The large variability between hospitals indicates that hospital-level interventions are crucial to improve PROM completeness and ensure reliable outcome assessment.