Background:

Limited literature has addressed impact of preoperative back pain severity on patient-reported outcome measures (PROMs), recovery ratios (RRs), and patient satisfaction following minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).

Methods:

MIS TLIFs were retrospectively identified and grouped: preoperative VAS back≤7 or VAS back>7. PROMs, including PROMIS-PF, VAS back and leg, ODI, and SF-12 PCS and MCS, were collected pre- and post-operatively. A PROM’s RR was calculated as proportion of postoperative improvement to overall potential improvement.

Results:

740 patients were included: 359 patients with VAS back≤7, 381 patients with VAS back>7. VAS back>7 cohort saw significantly greater postoperative inpatient pain (p≤0.003, both). All preoperative and the following postoperative PROMs favored VAS back≤7 cohort: PROMIS-PF 2-years, VAS back overall, SF-12 PCS 12-weeks and 1-year, SF-12 MCS 6-weeks/12-weeks, VAS leg 6-weeks, 12-weeks, 6-months, and 2-years, and ODI overall (p≤0.048, all). VAS back>7 cohort demonstrated higher delta PROMs for all VAS back and ODI except 2-years (p≤0.021, all). Greater proportion of VAS back>7 patients achieved MCID for VAS back overall, ODI 6-weeks/12-weeks, PROMIS-PF 6-weeks, and SF-12 MCS 6-weeks/6-months (p≤0.044, all). VAS back>7 cohort RR was significantly greater for VAS back 6-months and VAS leg 6-months/2-years (p≤0.034, all). VAS back≤7 cohort’s postoperative satisfaction was significantly higher for VAS back 12-weeks, VAS leg 12-weeks and ODI 6-weeks/12-weeks (p≤0.046, all).

Conclusion:

Patients with greater preoperative back pain demonstrated significantly worse postoperative scores for most PROMs at most time points and significantly worse patient satisfaction for disability, back and leg pain at multiple time points.