A 3-Year Study Investigating the Utility of Patient-Reported Outcomes Measurement Information System-29 for Long-Term Follow-Up in Adult Spinal Deformity

BACKGROUND: Adult spinal deformity (ASD) significantly impacts the quality of life due to three-dimensional spinal abnormalities. Patient-reported outcome measures, such as the Patient-Reported Outcomes Measurement Information System (PROMIS -29), play a crucial role in assessing postoperative outcomes. This study aims to investigate trends in PROMIS -29 scores over 36 months in patients undergoing long -segment thoracolumbar fusion for ASD and provide insights into its long-term utility. METHODS: A retrospective study including 163 ASD patients undergoing long -segment thoracolumbar fusion was conducted. PROMIS -29 scores were collected at baseline and at postoperative (0-), 3-, 6-, 12-, 18-, 24-, 30-, and 36-month follow-ups. Statistical analyses was performed to assess significant score changes from baseline and in consecutive recordings. RESULTS: Significant improvements in all PROMIS -29 categories were observed at 36 months, with the greatest changes in pain intensity ( - 35.19%, P < 0.001), physical function ( + 29.13%, P < 0.001), and pain interference ( - 28.8%, P < 0.001). Between the 0 and 3 month mark, the greatest significant changes were recorded in pain intensity ( - 26.5%, P < 0.001), physical function ( + 24.3%, P < 0.001), and anxiety ( - 16.9%, P < 0.018). However, scores plateaued after the 3-month mark, with zero categories showing significant changes with subsequent consecutive recordings. CONCLUSIONS: PROMIS -29 scores demonstrated notable improvements in ASD patients particularly in pain intensity, pain interference, and physical function. However, scores plateaued beyond the 3-month mark, suggesting PROMIS -29 's limited sensitivity to nuanced changes in long-term patient recovery. Future investigations exploring optimal combinations of patient reported outcome measures for comprehensive short- and long-term outcome assessments in ASD surgery would be beneficial.