PMID- 33003046
OWN - NLM
STAT- MEDLINE
DCOM- 20211025
LR  - 20211025
IS  - 2380-0194 (Electronic)
IS  - 2380-0186 (Linking)
VI  - 33
IP  - 9
DP  - 2020 Nov
TI  - The Association of Preoperative Duration of Symptoms With Clinical Outcomes and 
      Minimal Clinically Important Difference Following Anterior Cervical Discectomy 
      and Fusion.
PG  - 378-381
LID - 10.1097/BSD.0000000000001092 [doi]
AB  - STUDY DESIGN: This was a retrospective cohort study. OBJECTIVE: The purpose of 
      this study is to examine whether the time duration from symptom onset to 
      operative treatment is associated with postoperative clinical improvement after 
      anterior cervical discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA: There 
      is a paucity of literature regarding the influence of preoperative symptom 
      duration on patient-reported outcomes (PROs) following ACDF. METHODS: Patients 
      who underwent primary, single-level ACDF were retrospectively reviewed and 
      stratified according to preoperative symptom duration (<12 and >/=12 mo). 
      Demographic and perioperative characteristics were compared using chi analysis and 
      linear regression. Subgroup mean scores were compared and achievement of minimal 
      clinically important difference (MCID) was assessed for the Neck Disability Index 
      (NDI), Visual Analogue Scale (VAS) neck pain, VAS arm pain, and 12-Item 
      Short-Form Physical Component Score. RESULTS: A total of 109 patients underwent 
      primary, single-level ACDF: 68 had duration of symptoms (DOS) <12 months and 41 
      had a DOS >/=12 months. When comparing DOS subgroup preoperative PROs, there was no 
      preoperative difference in NDI, VAS arm or neck pain, and 12-Item Short-Form 
      Physical Component Score. In the postoperative period, there were no significant 
      differences in the improvement of PROs throughout the 12-month timepoint. A 
      significantly larger proportion of the <12 months DOS cohort achieved NDI MCID at 
      the 3-month (66.1% vs. 43.8%, P=0.039) and 6-month (76.8% vs. 53.6%, P=0.030) 
      postoperative period. CONCLUSIONS: Among the patient subgroups with <12 and >/=12 
      months DOS, there were no statistically significant differences observed in any 
      of the measured PRO means at any timepoint. When assessing MCID, however, 
      patients with shorter DOS (<12 mo) were observed to attain NDI MCID at the 3- and 
      6-month timepoints more often than patients with DOS >/=12 months. Our findings 
      suggest that delayed surgical intervention may impair functional recovery to MCID 
      in patients with degenerative cervical disease.
FAU - Jenkins, Nathaniel W
AU  - Jenkins NW
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.
FAU - Parrish, James M
AU  - Parrish JM
FAU - Lynch, Conor P
AU  - Lynch CP
FAU - Cha, Elliot D K
AU  - Cha EDK
FAU - Mohan, Shruthi
AU  - Mohan S
FAU - Geoghegan, Cara E
AU  - Geoghegan CE
FAU - Jadczak, Caroline N
AU  - Jadczak CN
FAU - Singh, Kern
AU  - Singh K
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Clin Spine Surg
JT  - Clinical spine surgery
JID - 101675083
SB  - IM
MH  - Cervical Vertebrae/surgery
MH  - Diskectomy
MH  - Humans
MH  - *Minimal Clinically Important Difference
MH  - Neck Pain
MH  - Retrospective Studies
MH  - *Spinal Fusion
MH  - Treatment Outcome
EDAT- 2020/10/02 06:00
MHDA- 2021/10/26 06:00
CRDT- 2020/10/01 20:22
PHST- 2020/10/02 06:00 [pubmed]
PHST- 2021/10/26 06:00 [medline]
PHST- 2020/10/01 20:22 [entrez]
AID - 01933606-202011000-00006 [pii]
AID - 10.1097/BSD.0000000000001092 [doi]
PST - ppublish
SO  - Clin Spine Surg. 2020 Nov;33(9):378-381. doi: 10.1097/BSD.0000000000001092.