222. Do grit and self-control impact outcomes following spine surgery: a retrospective analysis

BACKGROUND CONTEXT Grit, defined as perseverance and passion for long-term goals, and self-control, defined as the capacity to regulate impulses in the presence of momentarily gratifying temptations or diversion, have been shown to be important predictors for achievement in professional domains. Though grit and self-control have been well-explored in their relationship with achieving professional achievement, the association between these traits and outcomes following surgery has not been explored. PURPOSE To assess whether there is an association between grit/self-control and the achievement of minimum clinically important difference (MCID) following elective spine surgery. STUDY DESIGN/SETTING Retrospective review of prospectively collected data. PATIENT SAMPLE Consecutive patients who underwent primary elective spine surgery and had at least 1 year follow-up were included. The three surgical cohorts were: (1) anterior cervical surgery [anterior cervical discectomy and fusion (ACDF) or cervical disc replacement (CDR)], (2) Minimally invasive lumbar decompression [microdiscectomy or laminectomy (MI-D)], and (3) Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). OUTCOME MEASURES The validated 8-Question Short Grit Scale and the 10-Item Self-Scoring Self-Control Scale were used to assess grit and self-control, respectively. Both surveys are five-point scales, with five signifying the highest score (ie, more grit and self-control). Patient reported outcome measures included NDI for cervical patients and ODI for lumbar patients. Minimum Clinically Important Difference (MCID) values for each type of outcome measure were acquired from established literature. METHODS Grit and self-control scores were compared between patients who achieved MCID by a certain time-point and those who did not. The time-points were selected based on when the majority of patients in each cohort had achieved MCID. RESULTS Of the 69 patients included, 17 underwent ACDF/CDR, 28 underwent MI-D, and 24 underwent MI-TLIF. The mean grit and self-control scores for the ACDF/CDR cohort were 3.48 + 0.48 and 3.96 + 0.51, respectively. In this cohort, 64.3% of patients achieved MCID in NDI at 6 months. There were no significant differences in grit and self-control scores between patients who achieved MCID in NDI at 6 months postoperatively vs those who did not. The mean grit and self-control scores for the MI-D cohort were 3.96 + 0.57 and 3.82 + 0.61, respectively. In this cohort, 48% patients achieved MCID in ODI at 2 weeks. There were no significant differences in either score between patients who achieved MCID in ODI at 2 weeks postoperatively vs those who did not. The mean grit and self-control scores for the MI-TLIF cohort were 3.95 + 0.61 and 4.07 + 0.55, respectively. In this cohort, 59.1% of patients achieved MCID in ODI at 12 weeks. There were no significant differences in either score between patients who achieved MCID in ODI at 12-weeks vs those who did not. CONCLUSIONS Preliminary results show that grit and self-control scores are not associated with achievement of MCID following spine surgery. A larger study will need to be conducted to further evaluate the impact of grit and self-control. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.