IMPACT OF SCHEDULED SPINE SURGERY FOR DEGENERATIVE SPINAL DISORDERS ON PATIENT HEALTH-RELATED QUALITY OF LIFE COMPARED TO THE GENERAL CANADIAN POPULATION

The national impact of spinal disorders and spine surgery on health related quality of life (HRQOL) has not been well characterized. Our objective was to compare baseline and 1-year HRQOL from the Canadian Spine Outcomes and Research Network (CSORN) registry to their age-sex matched estimations in the general population. Retrospective review of CSORN registry patients with degenerative cervical or thoracolumbar pathology was performed. The outcomes were baseline and 1-year, physical component (PCS) and mental component summary scores (MCS) from the Short Form Health Survey (SF-12). Age-sex specific means and standard deviation for PCS and MCS, baseline and 1-year post-operative, were calculated for the cohort and compared to their corresponding values from the Canadian general population (CGP). 5495 patients were analysed. Baseline mean PCS was 50.5 (SD 9) overall for the CGP, decreasing with each decade of age. Across all pathoanatomical diagnoses and chief clinical complaints, the mean PCS was 29.4 at baseline and 40.2 at 12 months postoperative in the CSORN group. PCS improvement was greatest for lumbar disc herniation/radiculopathy (13.3/12) and least for cervical stenosis / myelopathy (6.7/6.1). MCS for all diagnoses and chief complaints also substantially improved at 1-year, however both baseline and 1-year scores were within 1 SD of the CGP values. In a surgical cohort, compared to the CGP, degenerative spinal disorders are associated with a dramatic reduction of HRQOL across all age and sex groups regardless of diagnosis or clinical presentation. In a representative national surgical cohort, spine intervention was impactful in restoring HRQOL to within 1 standard deviation of the age-sex match CGP across all common degenerative diagnosis and symptom presentations. The relatively normative MCS scores of our entire surgical cohort reflects appropriate patient selection as it pertains to the negative surgical prognostic implication of poor mental health.