• Oscar Covarrubias, Nicholas S Andrade, Kevin C Mo, Suraj Dhanjani, Jarod Olson, Farah N Musharbash, Rahul Sachdev, Khaled M Kebaish, Richard L Skolasky, and Brian J Neuman.
• Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD.
• Spine. 2024 May 15; 49 (10): 689693689-693.

Study DesignRetrospective review.ObjectivesTo evaluate (1) patient satisfaction after adult spine surgery; (2) associations between the number of abnormal PROMIS domain scores and postoperative satisfaction; and (3) associations between the normalization of a patient's worst preoperative PROMIS domain score and postoperative satisfaction.Summary Of Background DataAlthough "legacy" patient-reported outcome measures correlate with patient satisfaction after adult spine surgery, it is unclear whether PROMIS scores do.Materials And MethodsWe included 1119 patients treated operatively for degenerative spine disease (DSD) or adult spinal deformity (ASD) from 2014 to 2019 at our tertiary hospital who completed questionnaires preoperatively and at ≥1 postoperative time points up to two years. Postoperative satisfaction was measured in ASD patients using items 21 and 22 from the SRS 22-revised questionnaire and in DSD patients using the NASS Patient Satisfaction Index. The "Worst" preoperative PROMIS domain was that with the greatest clinically negative deviation from the mean. "Normalization" was a postoperative score within 1 SD of the general population mean. Multivariate logistic regression identified factors associated with satisfaction.ResultsSatisfaction was reported by 88% of DSD and 86% of ASD patients at initial postoperative follow-up; this proportion did not change during the first year after surgery. We observed an inverse relationship between postoperative satisfaction and the number of abnormal PROMIS domains at all postoperative time points beyond 6 weeks. Only among ASD patients was normalization of the worst preoperative PROMIS domain associated with greater odds of satisfaction at all time points up to one year.ConclusionThe proportion of DSD and ASD patients satisfied postoperatively did not change from six weeks to 1 year. Normalizing the worst preoperative PROMIS domain and minimizing the number of abnormal postoperative PROMIS scores may reduce the number of dissatisfied patients. PROMIS data can guide perioperative patient management to improve satisfaction.Level Of EvidenceLevel-3.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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