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Biopsychosocial variations in quality of life outcome following microdiscectomy

BACKGROUND: Lumbar microdiscectomy is one of the most frequently performed neurosurgical procedures. In this review, we ask why patients’ outcomes vary so widely even within the same unit, with the same surgeon performing the procedure and utilizing the technique? METHODS: In a cohort of 87 patients...

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Autores principales: Houlihan, Lena Mary, Meeke, James, Dunlea, Orla, O’Sullivan, Michael G. J., Lim, Chris, Kaar, George
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7656005/
https://www.ncbi.nlm.nih.gov/pubmed/33194273
http://dx.doi.org/10.25259/SNI_449_2020
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author Houlihan, Lena Mary
Meeke, James
Dunlea, Orla
O’Sullivan, Michael G. J.
Lim, Chris
Kaar, George
author_facet Houlihan, Lena Mary
Meeke, James
Dunlea, Orla
O’Sullivan, Michael G. J.
Lim, Chris
Kaar, George
author_sort Houlihan, Lena Mary
collection PubMed
description BACKGROUND: Lumbar microdiscectomy is one of the most frequently performed neurosurgical procedures. In this review, we ask why patients’ outcomes vary so widely even within the same unit, with the same surgeon performing the procedure and utilizing the technique? METHODS: In a cohort of 87 patients, we investigated how/whether multiple patient variables impacted outcomes following single-level lumbar microdiscectomy. We studied whether early surgical intervention improved the patients’ quality of life (QOL) versus late intervention. Furthermore, we assessed other variables that could influence patient-perceived improvement. Preoperatively and postoperatively, we additionally utilized the following internationally standardized questionnaires (EQ-5D, Oswestry, and Core Outcome Measures Index [COMI]). RESULTS: A generalized substantial improvement in QOL was identified throughout the cohort population (<0.05). There was no difference in health measurement scores for those undergoing early versus late surgery. However, there was a statistically significant improvement in all QOL scores for privately insured patients versus publicly insured patients (e.g., on COMI, EQ-5D, and ODI Scores). CONCLUSION: There was no objective statistically significant difference in QOL health scores between patients undergoing early versus late surgical lumbar microdiscectomy. This would suggest that the length of time patients is symptomatic before surgery did not significantly impact postoperative outcome. Of interest, however, was the difference in QOL health scores for private versus public patients suggesting that there are more subjective, complex, and psychosocial issues that influence outcome.
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spelling pubmed-76560052020-11-13 Biopsychosocial variations in quality of life outcome following microdiscectomy Houlihan, Lena Mary Meeke, James Dunlea, Orla O’Sullivan, Michael G. J. Lim, Chris Kaar, George Surg Neurol Int Original Article BACKGROUND: Lumbar microdiscectomy is one of the most frequently performed neurosurgical procedures. In this review, we ask why patients’ outcomes vary so widely even within the same unit, with the same surgeon performing the procedure and utilizing the technique? METHODS: In a cohort of 87 patients, we investigated how/whether multiple patient variables impacted outcomes following single-level lumbar microdiscectomy. We studied whether early surgical intervention improved the patients’ quality of life (QOL) versus late intervention. Furthermore, we assessed other variables that could influence patient-perceived improvement. Preoperatively and postoperatively, we additionally utilized the following internationally standardized questionnaires (EQ-5D, Oswestry, and Core Outcome Measures Index [COMI]). RESULTS: A generalized substantial improvement in QOL was identified throughout the cohort population (<0.05). There was no difference in health measurement scores for those undergoing early versus late surgery. However, there was a statistically significant improvement in all QOL scores for privately insured patients versus publicly insured patients (e.g., on COMI, EQ-5D, and ODI Scores). CONCLUSION: There was no objective statistically significant difference in QOL health scores between patients undergoing early versus late surgical lumbar microdiscectomy. This would suggest that the length of time patients is symptomatic before surgery did not significantly impact postoperative outcome. Of interest, however, was the difference in QOL health scores for private versus public patients suggesting that there are more subjective, complex, and psychosocial issues that influence outcome. Scientific Scholar 2020-10-15 /pmc/articles/PMC7656005/ /pubmed/33194273 http://dx.doi.org/10.25259/SNI_449_2020 Text en Copyright: © 2020 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Houlihan, Lena Mary
Meeke, James
Dunlea, Orla
O’Sullivan, Michael G. J.
Lim, Chris
Kaar, George
Biopsychosocial variations in quality of life outcome following microdiscectomy
title Biopsychosocial variations in quality of life outcome following microdiscectomy
title_full Biopsychosocial variations in quality of life outcome following microdiscectomy
title_fullStr Biopsychosocial variations in quality of life outcome following microdiscectomy
title_full_unstemmed Biopsychosocial variations in quality of life outcome following microdiscectomy
title_short Biopsychosocial variations in quality of life outcome following microdiscectomy
title_sort biopsychosocial variations in quality of life outcome following microdiscectomy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7656005/
https://www.ncbi.nlm.nih.gov/pubmed/33194273
http://dx.doi.org/10.25259/SNI_449_2020
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