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Review
. 2019 Feb;9(1):67-76.
doi: 10.1177/2192568217701104. Epub 2018 Jul 29.

Quality of Life in Patients Undergoing Spine Surgery: Systematic Review and Meta-Analysis

Nikhil R Nayak  1 , James H Stephen  1 , Matthew A Piazza  1 , Adetokunbo A Obayemi  1 , Sherman C Stein  1 , Neil R Malhotra  1
Affiliations
Review

Quality of Life in Patients Undergoing Spine Surgery: Systematic Review and Meta-Analysis

Nikhil R Nayak et al. Global Spine J. 2019 Feb.

Abstract

Study design: Meta-analysis.

Objective: Despite the increasing importance of tracking clinical outcomes using valid patient-reported outcome measures, most providers do not routinely obtain baseline preoperative health-related quality of life (HRQoL) data in patients undergoing spine surgery, precluding objective outcomes analysis in individual practices. We conducted a meta-analysis of pre- and postoperative HRQoL data obtained from the most commonly published instruments to use as reference values.

Methods: We searched PubMed, EMBASE, and an institutional registry for studies reporting EQ-5D, SF-6D, and Short Form-36 Physical Component Summary scores in patients undergoing surgery for degenerative cervical and lumbar spinal conditions published between 2000 and 2014. Observational data was pooled meta-analytically using an inverse variance-weighted, random-effects model, and statistical comparisons were performed.

Results: Ninety-nine articles were included in the final analysis. Baseline HRQoL scores varied by diagnosis for each of the 3 instruments. On average, postoperative HRQoL scores significantly improved following surgical intervention for each diagnosis using each instrument. There were statistically significant differences in baseline utility values between the EQ-5D and SF-6D instruments for all lumbar diagnoses.

Conclusions: The pooled HRQoL values presented in this study may be used by practitioners who would otherwise be precluded from quantifying their surgical outcomes due to a lack of baseline data. The results highlight differences in HRQoL between different degenerative spinal diagnoses, as well as the discrepancy between 2 common utility-based instruments. These findings emphasize the need to be cognizant of the specific instruments used when comparing the results of outcome studies.

Keywords: EQ-5Q; SF-6D; quality-of-life; spine outcomes; spine surgery.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Summary of literature search results, with numbers of articles reviewed and rationale for article exclusion.
See this image and copyright information in PMC

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