This is for our readers that treat chronic pain pts.
DG Journal Club
OBJECTIVE To compare patient-reported outcomes (PROMs), Minimum Clinical Important Difference Achievement (MCID), and perceived postoperative satisfaction following minimally invasive lumbar decompression (MIS LD) in patients stratified by self-identified gender.
METHODS Patients receiving single MIS LD were identified. PROMs administered preoperatively and postoperatively included PROMIS-PF, VAS back/leg pain, ODI, SF-12 PCS/MCS. Patients were grouped by self-identified gender. Propensity score matching was carried out. Mean PROM and postoperative satisfaction scores were compared between cohorts utilizing a two-sample t-test. Postoperative PROM improvement within each cohort was calculated with use of paired t-test. MCID achievement was determined by comparison to previously established threshold values. MCID achievement rates were compared among groups using simple logistic regression.
RESULTS 128 propensity score matched patients were included: 44 in female group and 84 in male group. The male group demonstrated worse VAS back at 12-weeks and ODI at 6-weeks(p<0.046, all). The female cohort achieved greater rates of MCID for ODI at 6-month timepoint(p<0.049). Patients in the self-identified female group demonstrated higher levels of postoperative satisfaction for VAS leg(6-weeks/12-weeks), VAS back(12-weeks), and ODI(6-weeks/12-weeks)(p<0.028, all). Additionally, patients in the self-identified female group demonstrated greater levels of satisfaction for lifting at 6-weeks and 12-weeks(p<0.014, all).
CONCLUSION Despite similar pre-operative baselines, post-operative improvement and clinical outcomes, our study suggests that self-identified males have poorer short-term satisfaction for disability, leg pain, back pain, and lifting versus patients in the self-identified female group. Self-identified gender may influence patient satisfaction and may be attributed to differing preoperative expectations at baseline for short term recovery.