• James W Nie, Timothy J Hartman, Hanna Pawlowski, Michael C Prabhu, Nisheka N Vanjani, Omolabake O Oyetayo, and Kern Singh.
• Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
• World Neurosurg. 2022 Nov 1; 167: e251e267e251-e267.

ObjectiveTo compare perioperative characteristics and patient-reported outcome measures (PROMs) in workers' compensation (WC) patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in either the inpatient/outpatient setting.MethodsPatients with WC undergoing 1-level MIS-TLIF were included. Patients were separated into inpatient/outpatient groups and demographically propensity score matched. PROMs included visual analog scale (VAS) back/VAS leg/Oswestry Disability Index (ODI)/12-item Short Form Physical Composite Score (SF-12 PCS)/Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF) preoperatively and 6 weeks, 12 weeks, 6 months, and 1 year postoperatively. Results were compared preoperatively and postoperatively and between cohorts. Minimum clinically important difference (MCID) achievement was determined through comparison with values established in the literature.ResultsA total of 216 patients were included (184 inpatient). The inpatient cohort (IC) showed worse perioperative outcomes in multiple measures (P < 0.034; all). The IC improved in all PROMs (P < 0.038; all), besides ODI at 6 weeks, SF-12 PCS at 6 weeks/6 months/1 year, and PROMIS-PF at 6 weeks. The outpatient cohort (OC) improved in VAS back at all time points and VAS leg at 6 months (P < 0.033; all). Between cohorts, the OC showed better scores with VAS leg/ODI/SF-12 PCS/PROMIS-PF at multiple time points (P < 0.031; all). Most of the IC achieved MCID, aside from ODI, whereas the OC achieved MCID in SF-12 PCS. MCID achievement between cohorts was higher in the IC at PROMIS-PF at 1 year and VAS back overall (P < 0.034; all).ConclusionsDespite more comorbidities and worse perioperative measures, the IC showed improved PROMs from preoperative to ≥1 follow-up visit, whereas the OC had improvement with only VAS back and leg. The IC showed multiple MCID achievements, whereas the OC showed MCID in only SF-12 PCS. These findings may help guide a surgeon's decision making between inpatient/outpatient lumbar surgery in the WC population.Copyright © 2022 Elsevier Inc. All rights reserved.

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