Objective:

To 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.

Methods:

Patients with WC undergoing 1-level MIS-TLIF were included. Patients were separated into inpatient/outpatient groups, and demographically propensity score matched. PROMs included VAS back/VAS leg/ODI/SF-12 PCS/PROMIS-PF preoperatively and 6-weeks/12-weeks/6-months/1-year postoperatively. Results were compared pre-/postoperatively, and between cohorts. MCID achievement was determined through comparison with values established in literature.

Results:

216 patients were included (184 inpatient). The inpatient cohort (IC) demonstrated 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 demonstrated better scores with VAS leg/ODI/SF-12 PCS/PROMIS-PF at multiple timepoints (p<0.031; all). Most of the IC achieved MCID, aside from ODI, while 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).

Conclusion:

Despite more comorbidities and worse perioperative measures, the IC demonstrated improved PROMs from preoperative to ≥1 follow up visit, whereas the OC only had improvement with VAS back and leg. The IC demonstrated multiple MCID achievements, whereas the OC only demonstrated MCID in SF-12 PCS. These findings may help guide a surgeon’s decision making between inpatient/outpatient lumbar surgery in the WC population.