What question did this study set out to answer?

To estimate minimal clinically important difference (MCID) thresholds for three common patient-reported outcome measures across four distinct lumbar spine pathologies.

May 7, 2023The Spine JournalOpen Access

Determining minimal clinically important difference estimates following surgery for degenerative conditions of the lumbar spine: analysis of the Canadian Spine Outcomes and Research Network (CSORN) registry

View Full Paper

Ask AI

Bookmark

Authors

JPJ. Denise PowerLa Trobe University APAnthony V. PerruccioUniversity Health Network MCMayilée CañizaresUniversity Health Network

Discussion

Member takes

Implication

Observational registry study reveals distinct clinically meaningful improvement thresholds across lumbar spine pathologies, indicating generic benchmarks should not guide surgical evaluation.

Key Points

To estimate minimal clinically important difference (MCID) thresholds for three common patient-reported outcome measures across four distinct lumbar spine pathologies.
Analyzed prospective Canadian Spine Outcomes and Research Network (CSORN) registry data from 2015 to 2018 across 2,152 surgical patients: lumbar spinal stenosis (n=856), degenerative spondylolisthesis (n=591), disc herniation (n=520), and degenerative disc disease (n=185).
Assessed presurgery and 1-year postsurgery Oswestry Disability Index (ODI) alongside back and leg Numeric Pain Rating Scales (NPRS), anchored to a 5-point transition rating of perceived improvement.
Estimated absolute and percentage change MCIDs for benefit and substantial benefit using receiver operating characteristic (ROC) curves with Youden's index optimization stratified by pathology group.
Absolute ODI improvement thresholds for benefit ranged from -10.0 (degenerative disc disease) to -16.9 (disc herniation), and from -13.8 (spinal stenosis) to -22.0 (spondylolisthesis and disc herniation) for substantial benefit.
Back and leg pain NPRS thresholds for benefit ranged from -2 to -3 points across all conditions, whereas substantial benefit required a -4.0 point reduction for back pain in all groups.
Percentage change thresholds ranged from -11.1% to -50.0% for benefit and -40.0% to -66.6% for substantial benefit, yielding correct classification rates between 71% and 89% that favored percentage change over absolute change in patients with extreme baseline scores.

Cite This Study

Power et al. (2023) studied this question.

synapsesocial.com/papers/6a993a9fba1957220e75d0c2 https://doi.org/10.1016/j.spinee.2023.05.001

View Full Paper

Ask AI

Bookmark

Implication

Observational registry study reveals distinct clinically meaningful improvement thresholds across lumbar spine pathologies, indicating generic benchmarks should not guide surgical evaluation.

Determining minimal clinically important difference estimates following surgery for degenerative conditions of the lumbar spine: analysis of the Canadian Spine Outcomes and Research Network (CSORN) registry

Discussion

Member takes

Implication

Key Points

Cite This Study

Determining minimal clinically important difference estimates following surgery for degenerative conditions of the lumbar spine: analysis of the Canadian Spine Outcomes and Research Network (CSORN) registry

Discussion

Member takes

Implication

Key Points

Cite This Study

Also Consider

Also Consider