Changes in pain, quality of life, sleep, and mental health after uncomplicated spinal neurosurgery in palestine: a prospective study of patient-reported outcomes

The use of patient-reported outcomes measures (PROMs) is an application of the volume-to-value-based healthcare services, and was quantitatively used in the field of neurosurgery. Therefore, the current study aimed to investigate the preoperative and early postoperative, as well as changes and factors of changes, in specific PROMs among spinal neurosurgery patients in a tertiary hospital in Palestine. The study was conducted using a prospective longitudinal design on a convenience sample of 99 lumbar and 35 cervical spine neurosurgery patients, who were interviewed to fill in a preoperative and one-month postoperative questionnaire that measures pain, quality of life (QoL), sleep quality, and mental health PROMs. Valid versions of Arabic translated tools were used, including Neck Disability Index (NDI), Oswestry Disability Index (ODI), EuroQoL (EQ-5D-5 L), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Patient Health Questionnaire (PHQ-9). Data were analyzed using SPSS with full commitment to ethical considerations of anonymity and confidentiality. The patients had a mean age of 49.16 years, and were 50.7% females, 74.6% married, 59.7% underwent discectomy, a mean diagnosis-to-operation period of 7.15 weeks, and used preoperative paracetamol (69.4%), cortisones (76.9%), and NSAIDs (59.7%). All PROMs showed significant early postoperative improvements (p-value < 0.001), where better NDI improvements are found among urban residents and congenital disease-related operations, better ODI improvement among tumor resection patients, without hormonal disorders or use of preoperative cortisones, while better EQ-VAS improvements found among patients who are younger, and did not use preoperative paracetamol or muscle relaxants, and better ESS improvement are shown among older patients (p-value < 0.05). The current study found an overall significant early postoperative improvement among spinal neurosurgery patients in PROMs of pain, QoL, sleep quality, and mental health. Several studies agree with the findings of the current study, with differences in the affecting factors related to sampling and population characteristics differences. Patient's engagement in preoperative education, resource allocation, and conduct of multicenter, interventional studies is recommended.