Purpose

To determine whether there is an association between preoperative 10-Item Patient Activation Measure (PAM-10) scores and clinical outcomes following MIS LD.

Methods

Patients undergoing a primary MIS LD were retrospectively reviewed and stratified according to their preoperative PAM-10 scores: “low PAM,” “moderate PAM,” and “high PAM.” Preoperative PAM score cohorts were tested for improvements in Oswestry Disability Index (ODI), 12-Item Short-Form Physical Component Score (SF-12 PCS), and Visual Analog Scale (VAS) back and leg pain using multivariate linear regression.

Results

Eighty-nine patients were included: 29 had a low PAM score, 32 had a moderate PAM score, and 28 had a high PAM score. Cohorts experienced similar preoperative VAS back pain, VAS leg pain, ODI, and SF-12 PCS. Patients with low PAM scores experienced a trend of higher pain scores throughout 6 months with VAS back pain being significant at 3 months and VAS leg pain being significant at 6-week and 3-month follow-up. Patients with lower PAM scores experienced a worse improvement in ODI at 6-week, 3-month, and 6-month timepoints. Lastly, patients with lower PAM scores demonstrated less improvement in SF-12 PCS at 3-month and 6-month follow-up.

Conclusions

Lower preoperative PAM scores were associated with worse improvement in clinical outcomes following MIS LD. Patients with lower PAM scores had diminished improvement in long-term patient-reported outcomes including ODI, SF-12, and VAS back and leg pain. Our investigation suggests that preoperative PAM assessments may be an effective tool to predict postoperative outcomes following MIS LD.

中文翻译：

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术前患者激活可预测微创腰椎减压后患者报告的结局改善。

目的

为了确定术前10项患者激活措施（PAM-10）评分与MIS LD后的临床结局之间是否存在关联。

方法

根据术前PAM-10评分（“低PAM”，“中度PAM”和“高PAM”）对接受原发MIS LD的患者进行回顾性检查和分层。术前PAM评分队列使用多元线性回归进行了Oswestry残疾指数（ODI），12项简短形式身体成分评分（SF-12 PCS）和视觉模拟量表（VAS）背部和腿部疼痛改善的测试。

结果

包括89位患者：29位患者的PAM评分低，32位患者的PAM评分中等，28位患者的PAM评分较高。队列经历了类似的术前VAS背痛，VAS腿痛，ODI和SF-12 PCS。PAM评分低的患者在整个6个月中经历了更高的疼痛评分趋势，VAS背痛在3个月时显着，VAS腿痛在6周和3个月的随访中显着。PAM评分较低的患者在6周，3个月和6个月的时间点ODI改善较差。最后，PAM评分较低的患者在3个月和6个月的随访中，SF-12 PCS的改善较少。

结论

术前PAM评分较低与MIS LD后临床预后的恶化有关联。PAM评分较低的患者在长期患者报告的结局包括ODI，SF-12和VAS背部和腿部疼痛方面的改善有所减弱。我们的研究表明，术前PAM评估可能是预测MIS LD后术后预后的有效工具。