Early NRS Leg and Back Thresholds Predict Clinical Recovery After MIS Transforaminal Lumbar Interbody Fusion for Degenerative Spine Disease.

Abstract

This retrospective study included patients who underwent primary one-level minimally invasive (MIS) transforaminal lumbar interbody fusion (TLIF) for degenerative lumbar spine conditions. To identify early predictors of failing to achieve the Oswestry Disability Index (ODI) minimum clinically important difference (MCID) 1 year post-surgery. Early identification of patients at risk of failing to achieve ODI-MCID is crucial for early intervention and improved postoperative counseling. Currently, no specific thresholds guide patient follow-up for optimal recovery. The assessment included demographic information, surgical details, and patient-reported outcome measures (PROMs). PROMs were collected postoperatively at 2-week, 6-week, and 12-week time points, as well as at 6 and 12 months. The study included 166 patients, with 34% failing to achieve ODI-MCID at 1 year. Early VAS back and leg scores were found to be significant predictors of ODI-MCID achievement. The optimal thresholds identified were 2.25 for early VAS back and 4.25 for early VAS leg. A rerun regression identified the thresholds as independent predictors of ODI-MCID, with odds ratios of 0.31 for both measures. VAS back and leg score thresholds at 6 to 12 weeks can predict ODI-MCID achievement 1 year after MIS TLIF. Patients exceeding the identified thresholds may be at risk of failing ODI-MCID and should be monitored closely. Level three.