Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec;16(Suppl 2):443-451.
doi: 10.1007/s11420-020-09817-w. Epub 2020 Nov 9.

Validating the VR-12 Physical Function Instrument After Anterior Cervical Discectomy and Fusion with SF-12, PROMIS, and NDI

Nathaniel W Jenkins  1 , James M Parrish  1 , Michael T Nolte  1 , Nadia M Hrynewycz  1 , Thomas S Brundage  1 , Kern Singh  1
Affiliations

Validating the VR-12 Physical Function Instrument After Anterior Cervical Discectomy and Fusion with SF-12, PROMIS, and NDI

Nathaniel W Jenkins et al. HSS J. 2020 Dec.

Abstract

Background: Development and validation of Veterans RAND 12-item (VR-12) physical component survey (PCS) has been established among civilian and veteran populations but it has not been examined among anterior cervical discectomy and fusion (ACDF) patients.

Purposes/questions: We sought to validate legacy patient-reported outcome measures (PROMs) with VR-12 PCS among patients undergoing ACDF procedures.

Methods: A prospectively collected surgical registry was retrospectively evaluated for elective single or multi-level ACDFs performed for degenerative spinal pathologies from January 2014 to August 2019. Exclusion criteria included missing pre-operative surveys and surgery for trauma, metastasis, or infection. Demographic variables, baseline pathologies, and peri-operative variables were collected. A paired t test evaluated the change from the pre-operative score to each post-operative timepoint for VR-12 PCS, the 12-item Short-Form Survey (SF-12) PCS, Patient-Reported Outcomes Measurement Information System physical function (PROMIS-PF), and Neck Disability Index (NDI). Minimal clinically important difference (MCID) achievement was calculated at each timepoint. Correlation was evaluated with a Pearson's correlation coefficient and time-independent partial correlation.

Results: Of the 202 patients who underwent ACDF, 41.1% were female and the average age was 49.5 years. All PROMs had statistically significantly increased from baseline when compared with post-operative timepoints (12 weeks, 6 months, 1 year, and 2 years). MCID achievement rates increased through 2 years. All timepoints revealed strong VR-12 PCS correlations with SF-12 PCS, PROMIS-PF, and NDI scores.

Conclusion: VR-12 PCS was strongly correlated with the well-validated SF-12 PCS and NDI metrics as well as with the more recent PROMIS-PF. All PROMs demonstrated statistically significant improvement in patients post-operatively. VR-12 PCS is a valid measure of physical function among patients undergoing ACDF.

Keywords: ACDF; anterior cervical discectomy and fusion; cervical surgery; patient-reported outcomes; physical function.

PubMed Disclaimer

Conflict of interest statement

Conflict of InterestNathaniel W. Jenkins, MS, James M. Parrish, MPH, Michael T. Nolte, MD, Nadia M. Hrynewycz, BS, and Thomas S. Brundage, BS, declare that they have no conflicts of interest. Kern Singh, MD, reports personal fees and royalties from Zimmer Biomet, royalties from Stryker, RTI Surgical, and Lippincott Williams and Wilkins, stock ownership from Avaz Surgical LLC, stock ownership and board membership from Vital 5 LLC, personal fees from K2M, non-financial support and board membership from TDi LLC, non-financial support from Minimally Invasive Spine Study Group, Contemporary Spine Surgery, Orthopedics Today, and Vertebral Columns, and grants from Cervical Spine Research Society, outside the submitted work.

Figures

Fig. 1
Fig. 1
ACDF pre-operative association of VR-12 with SF-12 and PROMIS
Fig. 2
Fig. 2
ACDF 6-week post-operative association of VR-12 with SF-12 and PROMIS.
Fig. 3
Fig. 3
ACDF 12-week post-operative association of VR-12 with SF-12 and PROMIS.
Fig. 4
Fig. 4
ACDF 6-month post-operative association of VR-12 with SF-12 and PROMIS.
Fig. 5
Fig. 5
ACDF 1-year post-operative association of VR-12 with SF-12 and PROMIS.
Fig. 6
Fig. 6
ACDF 2-year post-operative association of VR-12 with SF-12 and PROMIS.
See this image and copyright information in PMC

References

    1. Andresen AK, Paulsen RT, Busch F, Isenberg-Jørgensen A, Carreon LY, Andersen MØ. Patient-reported outcomes and patient-reported satisfaction after surgical treatment for cervical radiculopathy. Global Spine J. 2018;8:703–708. doi: 10.1177/2192568218765398. - DOI - PMC - PubMed
    1. Anon. AAOS File Uploads—NDI. Available at: https://www.aaos.org/uploadedFiles/NDI.pdf. Accessed 6 Apr 2020.
    1. Auffinger B, Lam S, Shen J, Thaci B, Roitberg BZ. Usefulness of minimum clinically important difference for assessing patients with subaxial degenerative cervical spine disease: statistical versus substantial clinical benefit. Acta Neurochir. 2013;155:2345–2355. doi: 10.1007/s00701-013-1909-4. - DOI - PubMed
    1. Boody BS, Bhatt S, Mazmudar AS, Hsu WK, Rothrock NE, Patel AA. Validation of Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive tests in cervical spine surgery. J Neurosurg Spine. 2018;28:268–279. doi: 10.3171/2017.7.SPINE17661. - DOI - PMC - PubMed
    1. Carreon LY, Glassman SD, Campbell MJ, Anderson PA. Neck Disability Index, short form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion. Spine J. 2010;10:469–474. doi: 10.1016/j.spinee.2010.02.007. - DOI - PubMed