Pain alleviation and functional improvement: ultra-early patient-reported outcome measures after full endoscopic spine surgery.

OBJECTIVE: Questions regarding anticipated pain improvement and functional recovery postsurgery are frequently posed in preoperative consultations. However, a lack of data characterizing outcomes for the first postoperative days only allows for anecdotal answers. Hence, the assessment of ultra-early patient-reported outcome measures (PROMs) is essential for patient-provider communication and patient satisfaction. The aim of this study was to elucidate this research gap by assessing and characterizing PROMs for the first days after full endoscopic spine surgery (FESS). METHODS: This multicenter study included patients undergoing lumbar FESS from March 2021 to July 2023. After informed consent was provided, data were collected prospectively through a smartphone application. Patients underwent either discectomy or decompression. Analyzed parameters included demographics, surgical details, visual analog scale scores for both back and leg pain, and the Oswestry Disability Index (ODI) score. Data were acquired daily for the 1st postoperative week, as well as after 2 weeks, 3 months, and 6 months. RESULTS: A total of 182 patients were included, of whom 102 underwent FESS discectomy and 80 underwent FESS decompression. Significant differences between the discectomy and decompression groups were found for age (mean 50.45 ± 15.28 years and 63.85 ± 13.25 years, p < 0.001; respectively), sex (p = 0.007), and surgery duration (73.45 ± 45.23 minutes vs 98.05 ± 46.47 minutes, p < 0.001; respectively). Patients in both groups reported a significant amelioration of leg pain on the 1st postoperative day (discectomy group VAS score: 6.2 ± 2.6 vs 2.4 ± 2.9, p < 0.001; decompression group: 5.3 ± 2.8 vs 1.9 ± 2.2, p < 0.001) and of back pain within the 1st postoperative week (discectomy group VAS score: 5.5 ± 2.8 vs 2.8 ± 2.2, p < 0.001; decompression group: 5.2 ± 2.7 vs 3.1 ± 2.4, p < 0.001). ODI score improvement was most pronounced at the 3-month time point (discectomy group: 21.7 ± 9.1 vs 9.3 ± 9.1, p < 0.001; decompression group: 19.3 ± 7.8 vs 9.9 ± 8.3, p < 0.001). For both groups, pain improvement within the 1st week after surgery was highly predictive of later benefits. CONCLUSIONS: Ultra-early PROMs reveal an immediate pain improvement after FESS. While the benefits in pain reduction plateaued within the 1st postoperative week for both groups, functional improvements developed over a more extended period. These results illustrate a biphasic rehabilitation process wherein initial pain alleviation transitions into functional improvement over time.

Beauty Beware: Associations between Perceptions of Harm and Safer Hair-Product-Purchasing Behaviors in a Cross-Sectional Study of Adults Affiliated with a University in the Northeast.

(1) Background: Widespread personal care product (PCP) use can expose individuals to endocrine-disrupting chemicals (EDCs) associated with adverse health outcomes. This study investigated the association between harm perceptions and hair-product-purchasing behaviors in adults enrolled in a cross-sectional study. (2) Methods: Respondents rated their agreement with five PCP-related harm statements using a five-point Likert scale. Multivariable-adjusted logistic regression models were used to examine the associations between harm perceptions with hair-product-purchasing behaviors and hair product use (i.e., number of products used). (3) Results: Among 567 respondents (non-Hispanic White, 54.9%; non-Hispanic Black, 9.5%; Hispanic/Latinx, 10.1%; Asian American/Pacific Islander, 20.1%; and multiracial/other, 5.5%), stronger harm perceptions around PCP use were associated with potentially "safer" hair-product-purchasing behaviors. Respondents who strongly agreed that consumers should be concerned about the health effects of PCPs had more than fourfold increased odds of always/usually using healthy product apps (OR 4.10, 95% CI: 2.04-8.26); reading ingredient labels (OR 4.53, 95% CI: 2.99-6.87); and looking for natural, non-toxic, or eco-friendly product labels (OR 4.53, 95% CI: 2.99-6.88) when buying hair products. (4) Conclusions: Promoting environmental health literacy and raising awareness of potential PCP use-related harms might encourage healthier hair product use behaviors.