• Andrea H Johnson, Jane C Brennan, Parimal Rana, Sarah Hall, Justin J Turcotte, and Chad Patton.
• Luminis Health Anne Arundel Medical Center, Annapolis, Maryland.
• Spine. 2024 Aug 28.

Study DesignRetrospective Review.ObjectiveThe purpose of this study is to examine the effect of preoperative symptom duration on postoperative clinical outcomes for patients undergoing lumbar fusion surgery.Summary Of Background DataLumbar fusion surgery can be significantly beneficial for lumbar spondylolisthesis and spinal stenosis. Surgical treatment is typically preceded by some amount of non-operative intervention and there isn't a consensus on the optimal timing between symptom onset and surgical intervention.MethodsA retrospective review of 144 patients undergoing a 1-3 level lumbar fusion from June 2020 to December 2023 was performed. Demographics, preoperative symptom onset, primary diagnosis, and surgical procedure were compared between patients with less than or greater than 2 years of symptoms. Postoperative outcomes and PROMIS-PF were compared between groups. Univariate and multivariate analyses were performed.Results52 (36.1%) had symptoms for 2 years or longer while 92 (63.9%) had symptoms for less than 2 years. There was no difference in demographics, procedure type, primary diagnosis, or preoperative symptoms between those who had symptoms for greater than or less than 2 years. Those who had symptoms for 2+ years had a significantly lower change in PF (4.7±7.1 vs. 7.7±9.0; P=0.029) and lower rate of MCID achievement (44.2% vs. 65.2%; P=0.023). There was no difference in outcomes by symptom duration. On multivariate analysis those with symptoms of 2 years or more were 2.4 times less likely to achieve an MCID (OR: 0.42, 95% CI: 0.19 to 0.92; P=0.031).ConclusionPatients undergoing lumbar fusion with greater than 2 years of symptoms prior to surgery have a smaller increase in PROMIS-PF and are less likely to achieve MCID on PROMIS-PF. Further study is needed in order to determine the optimal timing for lumbar fusion surgery following symptom onset.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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