PMID- 34218619
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  - Preoperative Neck Disability Severity Limits Extent of Postoperative Improvement 
      Following Cervical Spine Procedures.
PG  - 377-388
LID - 10.14245/ns.2142084.042 [doi]
AB  - OBJECTIVE: Our study aims to evaluate the impact of severity of preoperative Neck 
      Disability Index (NDI) on postoperative patient-reported outcome measures 
      (PROMs). METHODS: A retrospective review of primary, elective, single or 
      multilevel anterior cervical discectomy and fusion or cervical disc arthroplasty 
      procedures between 2013 and 2019 was performed. Visual analogue scale (VAS) neck 
      and arm, NDI, 12-item Short Form physical and mental composite score (SF-12 PCS 
      and MCS), Patient-Reported Outcome Measurement Information System physical 
      function, and 9-item Patient Health Questionnaire (PHQ-9) were collected 
      preoperatively and postoperatively. Patients were categorized by preoperative 
      NDI: none-to-mild disability ( < 30); moderate disability ( >/= 30 to < 50); severe 
      disability ( >/= 50 to < 70); complete disability ( >/= 70). The impact of 
      preoperative NDI on PROM scores and minimum clinically important difference 
      (MCID) achievement rates were evaluated. RESULTS: The cohort included 74 patients 
      with none-to-mild disability, 95 moderate, 76 severe, and 17 with complete 
      disability. Patients with greater preoperative disability demonstrated 
      significantly different scores for NDI, VAS neck, SF-12 MCS, and PHQ-9 at all 
      timepoints (p < 0.001). Patients with more severe disability demonstrated 
      different magnitudes of improvement for NDI (all p < 0.001), VAS neck (p </= 
      0.009), VAS arm (p = 0.025), and PHQ-9 (p </= 0.011). The effect of preoperative 
      severity on MCID achievement was demonstrated for NDI and for PHQ-9 (p </= 0.007). 
      CONCLUSION: Patients with severe neck disability demonstrated differences in 
      pain, disability, physical and mental health. MCID achievement also differed by 
      preoperative symptoms severity. Patients with more severe neck disability may be 
      limited to the degree of improvement in quality of life but perceive them as 
      significant changes.
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 - 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 - Jadczak, Caroline N
AU  - Jadczak CN
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 - PMC8255767
OTO - NOTNLM
OT  - Cervical fusion
OT  - Neck Disability Index
OT  - Outcomes
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- 2021/01/14 00:00 [received]
PHST- 2021/04/07 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.2142084.042 [pii]
AID - ns-2142084-042 [pii]
AID - 10.14245/ns.2142084.042 [doi]
PST - ppublish
SO  - Neurospine. 2021 Jun;18(2):377-388. doi: 10.14245/ns.2142084.042. Epub 2021 Jun 
      30.