PMID- 34218609
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210717
IS  - 2586-6583 (Print)
IS  - 2586-6591 (Electronic)
IS  - 2586-6591 (Linking)
VI  - 18
IP  - 2
DP  - 2021 Jun
TI  - Comorbidity Influence on Postoperative Outcomes Following Anterior Cervical 
      Discectomy and Fusion.
PG  - 271-280
LID - 10.14245/ns.2040646.323 [doi]
AB  - OBJECTIVE: This study aims to detail the association between comorbidity burden 
      and achieving minimum clinically important difference (MCID) following anterior 
      cervical discectomy and fusion (ACDF). METHODS: A prospective surgical registry 
      was retrospectively reviewed. Patients with missing preoperative Patient-Reported 
      Outcomes Measurement Information System physical function (PROMIS PF) were 
      excluded. Patients were stratified by Charlson Comorbidity Index (CCI): no 
      comorbidities = 0 point; low CCI = 1-2 points; high CCI = >/= 3 points. Demographic 
      and perioperative characteristics were collected and evaluated for differences. 
      Visual analogue scale (VAS), 12-item Short Form health survey (SF-12), and PROMIS 
      PF were collected pre- and postoperatively and assessed for differences. 
      Differences in achievement of MCID were compared using established values: VAS 
      neck = 2.6, VAS arm = 4.1, NDI = 8.5, SF-12 physical composite score (SF-12 PCS) 
      = 8.1, PROMIS PF = 4.5. RESULTS: One hundred twenty-five ACDF patients were 
      included: 37 had no comorbidities, 64 with low CCI, and 24 with high CCI. Higher 
      CCI groups were older, nonsmokers, diabetic, arthritic, hypertensive, and had 
      cancer. Multilevel fusions, operative time, length of stay, and later discharge 
      day were associated with high CCI. VAS neck differed preoperatively by group. 
      SF-12 PCS and PROMIS PF were inversely associated with CCI groups. CCI did not 
      impact achievement of MCID for all outcomes. A lower rate of reaching MCID was 
      demonstrated at 3 months for SF-12 PCS. CONCLUSION: Regardless of comorbidity 
      burden, patients undergoing ACDF for cervical pathology demonstrated a similar 
      rate of achieving MCID for VAS neck, VAS arm, NDI, and PROMIS PF. Regardless of 
      CCI score, ACDF can have a significant benefit for patients.
FAU - Cha, Elliot D K
AU  - Cha EDK
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Lynch, Conor P
AU  - Lynch CP
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Jadczak, Caroline N
AU  - Jadczak CN
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Mohan, Shruthi
AU  - Mohan S
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Geoghegan, Cara E
AU  - Geoghegan CE
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Singh, Kern
AU  - Singh K
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
LA  - eng
PT  - Journal Article
DEP - 20210630
PL  - Korea (South)
TA  - Neurospine
JT  - Neurospine
JID - 101724936
PMC - PMC8255775
OTO - NOTNLM
OT  - Cervical fusion
OT  - Clinically important difference
OT  - Comorbidity
OT  - Outcome measures
COIS- The authors have nothing to disclose.
EDAT- 2021/07/06 06:00
MHDA- 2021/07/06 06:01
PMCR- 2021/06/01
CRDT- 2021/07/05 01:24
PHST- 2020/10/10 00:00 [received]
PHST- 2020/12/11 00:00 [accepted]
PHST- 2021/07/05 01:24 [entrez]
PHST- 2021/07/06 06:00 [pubmed]
PHST- 2021/07/06 06:01 [medline]
PHST- 2021/06/01 00:00 [pmc-release]
AID - ns.2040646.323 [pii]
AID - ns-2040646-323 [pii]
AID - 10.14245/ns.2040646.323 [doi]
PST - ppublish
SO  - Neurospine. 2021 Jun;18(2):271-280. doi: 10.14245/ns.2040646.323. Epub 2021 Jun 
      30.