Objectives: Patient Reported Outcomes Measurement Information System (PROMIS) has been shown to outperform and be a more efficient means of recording outcome measures in spine patients1. Lumbar medial branch radiofrequency ablation(RFA) has been established as an effective treatment for symptomatic facet arthropathy2, 3. We aim to determine if PROMIS can be used as an efficient means to capture outcomes of patients undergoing first-time, unilateral medial branch RFA.
Design: Retrospective analysis was conducted at a single academic spine center. All patients included in the study had clinical evidence of lumbar facet syndrome and positive diagnostic medial branch blocks (MBB) utilizing a dual comparative block paradigm prior to undergoing medial branch RFA. PROMIS score domains of Depression(D), Pain Interference(PI), and Physical Function(PF) were collected pre and post medial branch RFA. Pre-treatment scores were established within 6 weeks prior to the first MBB. Post-treatment scores were established at follow-up, between 5 weeks and 6 months, utilizing the score closest to 8 weeks. Paired-sample t-test was done to calculate the responsiveness to treatment, with significance assigned as p< 0.05. The effect size was measured using the standard calculation for Cohen’s d, where d=0.2, 0.5, and 0.8 correspond to small, medium, and large effects, respectively.
Results: 39 patients were included in the analysis. PROMIS PI (63.91, 61.29, p=0.004) and PF (37.21, 39.21, p=0.017) demonstrated statistically significant improvement in scores. PROMIS D (51.16, 49.94, p=0.12) did not demonstrate a statistically significant changes The effect size was medium (d=0.43) for PI, small/medium (d=0.31) for PF, and small (d=-0.12) for D.
Conclusions: The improvement in PI and PF establish that PROMIS scores are efficient in capturing clinical outcomes in this patient population and consistent with legacy outcome measures in demonstrating treatment effect of lumbar medial branch RFA.
Ramzi El-Hassan– Resident Physician, University of Rochester Medical Center
James Snyder– Resident Physician / Chief Resident, University of Rochester Medical Center
Adam Michalik– Resident Physician / Chief Resident, University of Rochester Medical Center
Rajeev Patel– Chairman / Physical Medicine and Rehabilitation, University of Rochester Medical Center
Clifford Everett– Associate Professor, University of Rochester Medical Center