PMID- 24694684
OWN - NLM
STAT- MEDLINE
DCOM- 20151116
LR  - 20220321
IS  - 1539-2465 (Electronic)
IS  - 1536-0652 (Linking)
VI  - 28
IP  - 3
DP  - 2015 Apr
TI  - Radiographic variables that may predict clinical outcomes in cervical disk 
      replacement surgery.
PG  - 106-13
LID - 10.1097/BSD.0b013e31826a0c84 [doi]
AB  - STUDY DESIGN: Retrospective analysis of prospectively collected data. OBJECTIVE: 
      To determine which, if any, radiographic parameters are predictive of clinical 
      outcome after cervical disk replacement (CDR) surgery. SUMMARY OF BACKGROUND 
      DATA: It is unclear whether radiographic parameters are predictive of outcome 
      after CDR. METHODS: An analysis of the radiographic parameters and clinical 
      outcomes of the CDR cohort of the Discover artificial cervical disk IDE trial was 
      performed. Clinical outcome measures included Neck Disability Index (NDI), visual 
      analog pain scale (neck, arm, and shoulder), and SF-36 physical component summary 
      score scores, collected preoperatively and at regularly scheduled postoperative 
      time periods. Patients with at least 1-year follow-up were included. The change 
      in outcomes from baseline was determined at each follow-up interval. The 
      following minimal clinically important difference (MCID) thresholds were applied: 
      -7.5 for NDI, -25 for visual analog pain scale, and +4.1 for physical component 
      summary score. Fifty-six radiographic variables were analyzed to identify factors 
      that may be associated with a poor clinical outcome, defined as failure to 
      achieve the MCID in NDI. RESULTS: A total of 243 patients underwent CDR at 304 
      levels (182 one level, 61 two level). One hundred seventy-one patients (89 
      female, 82 male; mean age, 44.2 y; range, 28-67 y) had at least 1-year follow-up. 
      A preoperative disk height of <3.5 mm was associated with a 3.4 times greater 
      risk of not achieving a MCID in NDI (P=0.018). Increasing the functional spinal 
      unit angle by >3 degrees was associated with a 3.5 times greater risk of not 
      achieving a MCID in NDI (P=0.016). There were 21/171 patients (25 levels) who did 
      not achieve the NDI MCID threshold. All of these patients had at least1, and 
      16/21 of these patients had more than 1 abnormal radiographic finding. Seventy 
      percent of treatment levels had severe or bridging heterotopic ossification at 
      3-years follow-up, the incidence of which increased linearly with time. 
      CONCLUSIONS: Several radiographic variables are predictive of clinical outcomes, 
      including decreased preoperative disk space height and excessive postoperative 
      segmental lordosis.
FAU - Rihn, Jeffrey A
AU  - Rihn JA
AD  - *The Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA 
      daggerMedical Metrics, Houston, TX.
FAU - Radcliff, Kristen
AU  - Radcliff K
FAU - Hipp, John
AU  - Hipp J
FAU - Vaccaro, Alexander R
AU  - Vaccaro AR
FAU - Hilibrand, Alan S
AU  - Hilibrand AS
FAU - Anderson, David G
AU  - Anderson DG
FAU - Albert, Todd J
AU  - Albert TJ
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Spinal Disord Tech
JT  - Journal of spinal disorders & techniques
JID - 101140323
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cervical Vertebrae/*diagnostic imaging/*surgery
MH  - Female
MH  - Humans
MH  - Intervertebral Disc Displacement/*diagnostic imaging/*surgery
MH  - Lordosis/diagnostic imaging
MH  - Male
MH  - Middle Aged
MH  - Pain/etiology/prevention & control
MH  - Pain Measurement
MH  - Radiography
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2014/04/04 06:00
MHDA- 2015/11/17 06:00
CRDT- 2014/04/04 06:00
PHST- 2014/04/04 06:00 [entrez]
PHST- 2014/04/04 06:00 [pubmed]
PHST- 2015/11/17 06:00 [medline]
AID - 10.1097/BSD.0b013e31826a0c84 [doi]
PST - ppublish
SO  - J Spinal Disord Tech. 2015 Apr;28(3):106-13. doi: 10.1097/BSD.0b013e31826a0c84.