PMID- 31328090
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220409
IS  - 2211-4599 (Print)
IS  - 2211-4599 (Electronic)
IS  - 2211-4599 (Linking)
VI  - 13
IP  - 3
DP  - 2019 Jun
TI  - Risk Factors Associated With Failure to Reach Minimal Clinically Important 
      Difference in Patient-Reported Outcomes Following Anterior Cervical Discectomy 
      and Fusion.
PG  - 262-269
LID - 10.14444/6035 [doi]
AB  - BACKGROUND: The minimum clinically importance difference (MCID) represents a 
      threshold for improvements in patient-reported outcomes (PROs) that patients deem 
      important. No previous study has comprehensively examined risk factors for 
      failure to achieve MCID after anterior cervical discectomy and fusion (ACDF) 
      procedures for radiculopathic symptomatology. The purpose of this study is to 
      determine risk factors for failure to reach MCID for Neck Disability Index (NDI), 
      Visual Analog Scale (VAS) neck pain, and VAS arm pain in patients undergoing 1- 
      or 2-level ACDF procedures. METHODS: A surgical registry of patients who 
      underwent primary, 1- or 2-level ACDF from 2014 to 2016 was reviewed. Rates of 
      MCID achievement for NDI, VAS neck pain, and VAS arm pain at final follow-up were 
      calculated based on published MCID values. Patients were then categorized into 
      demographic and procedural categories. Bivariate regression was used to test for 
      association of demographic and procedural characteristics with failure to reach 
      MCID for each PRO. The final multivariate model including all demographic and 
      procedural categories as controls was created using backward stepwise regression. 
      RESULTS: Eighty-three, 84, and 77 patients were included in the analysis for VAS 
      neck, VAS arm, and NDI, respectively. Rates of MCID achievement for VAS neck, VAS 
      arm, and NDI were 55.4%, 36.9%, and 76.6%, respectively. On bivariate analysis, 
      patients with Charlson Comorbidity Index (CCI) >/= 2 were less likely to achieve 
      MCID for NDI than patients with CCI < 2 (P = .025). On multivariate analysis, CCI 
      >/= 2 (P = .025) was further associated with failure to reach MCID for NDI. 
      CONCLUSIONS: The results of this study suggest that the majority of patients do 
      not reach MCID for arm pain. Additionally, higher comorbidity burden as evidenced 
      by higher CCI scores is a negative predictive factor for the achievement of MCID 
      in neck disability following ACDF. LEVEL OF EVIDENCE: 3.
FAU - Narain, Ankur S
AU  - Narain AS
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 West 
      Harrison Street, Suite #300, Chicago, IL 60612.
FAU - Hijji, Fady Y
AU  - Hijji FY
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 West 
      Harrison Street, Suite #300, Chicago, IL 60612.
FAU - Khechen, Benjamin
AU  - Khechen B
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 West 
      Harrison Street, Suite #300, Chicago, IL 60612.
FAU - Haws, Brittany E
AU  - Haws BE
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 West 
      Harrison Street, Suite #300, Chicago, IL 60612.
FAU - Patel, Dil V
AU  - Patel DV
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 West 
      Harrison Street, Suite #300, Chicago, IL 60612.
FAU - Bohl, Daniel D
AU  - Bohl DD
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 West 
      Harrison Street, Suite #300, Chicago, IL 60612.
FAU - Yom, Kelly H
AU  - Yom KH
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 West 
      Harrison Street, Suite #300, Chicago, IL 60612.
FAU - Kudaravalli, Krishna T
AU  - Kudaravalli KT
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 West 
      Harrison Street, Suite #300, Chicago, IL 60612.
FAU - Singh, Kern
AU  - Singh K
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611 West 
      Harrison Street, Suite #300, Chicago, IL 60612.
LA  - eng
PT  - Journal Article
DEP - 20190630
PL  - Netherlands
TA  - Int J Spine Surg
JT  - International journal of spine surgery
JID - 101579005
PMC - PMC6625705
OTO - NOTNLM
OT  - Charlson Comorbidity Index
OT  - Neck Disability Index
OT  - Visual Analog Scale
OT  - anterior cervical discectomy and fusion
OT  - arm pain
OT  - minimal clinically important difference
OT  - neck pain
COIS- Disclosures and COI: No funds were received in support of this work. No benefits 
      in any form have been or will be received from any commercial party related 
      directly or indirectly to the subject of this manuscript.
EDAT- 2019/07/23 06:00
MHDA- 2019/07/23 06:01
PMCR- 2019/06/30
CRDT- 2019/07/23 06:00
PHST- 2019/07/23 06:00 [entrez]
PHST- 2019/07/23 06:00 [pubmed]
PHST- 2019/07/23 06:01 [medline]
PHST- 2019/06/30 00:00 [pmc-release]
AID - 10.14444/6035 [doi]
PST - epublish
SO  - Int J Spine Surg. 2019 Jun 30;13(3):262-269. doi: 10.14444/6035. eCollection 2019 
      Jun.