PMID- 32470935
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240517
IS  - 1547-5646 (Electronic)
IS  - 1547-5646 (Linking)
VI  - 33
IP  - 4
DP  - 2020 May 29
TI  - Establishing the minimum clinically important difference in Neck Disability Index 
      and modified Japanese Orthopaedic Association scores for adult cervical 
      deformity.
PG  - 441-445
LID - 10.3171/2020.3.SPINE191232 [doi]
AB  - OBJECTIVE: It is being increasingly recognized that adult cervical deformity 
      (ACD) is correlated with significant pain, myelopathy, and disability, and that 
      patients who undergo deformity correction gain significant benefit. However, 
      there are no defined thresholds of minimum clinically important difference (MCID) 
      in Neck Disability Index (NDI) and modified Japanese Orthopaedic Association 
      (mJOA) scores. METHODS: Patients of interest were consecutive patients with ACD 
      who underwent cervical deformity correction. ACD was defined as C2-7 sagittal 
      Cobb angle >/= 10 degrees  (kyphosis), C2-7 coronal Cobb angle >/= 10 degrees  (cervical scoliosis), 
      C2-7 sagittal vertical axis >/= 4 cm, and/or chin-brow vertical angle >/= 25 degrees . Data 
      were obtained from a consecutive cohort of patients from a multiinstitutional 
      prospective database maintained across 13 sites. Distribution-based MCID, 
      anchor-based MCID, and minimally detectable measurement difference (MDMD) were 
      calculated. RESULTS: A total of 73 patients met inclusion criteria and had 
      sufficient 1-year follow-up. In the cohort, 42 patients (57.5%) were female. The 
      mean age at the time of surgery was 62.23 years, and average body mass index was 
      29.28. The mean preoperative NDI was 46.49 and mJOA was 13.17. There was 
      significant improvement in NDI at 1 year (46.49 vs 37.04; p = 0.0001). There was 
      no significant difference in preoperative and 1-year mJOA (13.17 vs 13.7; p = 
      0.12). Using multiple techniques to yield MCID thresholds specific to the ACD 
      population, the authors obtained values of 5.42 to 7.48 for the NDI, and 1.00 to 
      1.39 for the mJOA. The MDMD was 6.4 for the NDI, and 1.8 for the mJOA. Therefore, 
      based on their results, the authors recommend using an MCID threshold of 1.8 for 
      the mJOA, and 7.0 for the NDI in patients with ACD. CONCLUSIONS: The ACD-specific 
      MCID thresholds for NDI and mJOA are similar to the reported MCID following 
      surgery for degenerative cervical disease. Additional studies are needed to 
      verify these findings. Nonetheless, the findings here will be useful for future 
      studies evaluating the success of surgery for patients with ACD undergoing 
      deformity correction.
FAU - Soroceanu, Alex
AU  - Soroceanu A
AD  - 1Department of Orthopaedic Surgery, University of Calgary, Alberta, Canada.
FAU - Smith, Justin S
AU  - Smith JS
AD  - 2Department of Neurosurgery, University of Virginia Health System, 
      Charlottesville, Virginia.
FAU - Lau, Darryl
AU  - Lau D
AD  - 3Department of Neurological Surgery, University of California, San Francisco, 
      California.
FAU - Kelly, Michael P
AU  - Kelly MP
AD  - 4Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri.
FAU - Passias, Peter G
AU  - Passias PG
AD  - 5Department of Orthopaedic Surgery, New York University, New York, New York.
FAU - Protopsaltis, Themistocles S
AU  - Protopsaltis TS
AD  - 5Department of Orthopaedic Surgery, New York University, New York, New York.
FAU - Gum, Jeffrey L
AU  - Gum JL
AD  - 6Department of Orthopaedic Surgery, Norton Leatherman Spine Center, Louisville, 
      Kentucky.
FAU - Lafage, Virginie
AU  - Lafage V
AD  - 7Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New 
      York.
FAU - Kim, Han-Jo
AU  - Kim HJ
AD  - 7Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New 
      York.
FAU - Scheer, Justin K
AU  - Scheer JK
AD  - 3Department of Neurological Surgery, University of California, San Francisco, 
      California.
FAU - Gupta, Munish
AU  - Gupta M
AD  - 4Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri.
FAU - Mundis, Gregory M
AU  - Mundis GM
AD  - 8Department of Orthopaedic Surgery, Scripps, San Diego, California.
FAU - Klineberg, Eric O
AU  - Klineberg EO
AD  - 9Department of Orthopaedic Surgery, University of California, Davis, Sacramento, 
      California.
FAU - Burton, Douglas
AU  - Burton D
AD  - 10Department of Orthopaedic Surgery, University of Kansas, Kansas City, Kansas; 
      and.
FAU - Bess, Shay
AU  - Bess S
AD  - 11Department of Orthopaedic Surgery, Denver International Spine Center, Denver, 
      Colorado.
FAU - Ames, Christopher P
AU  - Ames CP
AD  - 3Department of Neurological Surgery, University of California, San Francisco, 
      California.
CN  - International Spine Study Group
LA  - eng
PT  - Journal Article
DEP - 20200529
PL  - United States
TA  - J Neurosurg Spine
JT  - Journal of neurosurgery. Spine
JID - 101223545
SB  - IM
OTO - NOTNLM
OT  - Neck Disability Index
OT  - cervical deformity
OT  - minimum clinically importance difference
OT  - modified Japanese Orthopaedic Association
EDAT- 2020/05/30 06:00
MHDA- 2020/05/30 06:01
CRDT- 2020/05/30 06:00
PHST- 2019/10/13 00:00 [received]
PHST- 2020/03/30 00:00 [accepted]
PHST- 2020/05/30 06:01 [medline]
PHST- 2020/05/30 06:00 [pubmed]
PHST- 2020/05/30 06:00 [entrez]
AID - 2020.3.SPINE191232 [pii]
AID - 10.3171/2020.3.SPINE191232 [doi]
PST - epublish
SO  - J Neurosurg Spine. 2020 May 29;33(4):441-445. doi: 10.3171/2020.3.SPINE191232.