PMID- 35460906
OWN - NLM
STAT- MEDLINE
DCOM- 20220623
LR  - 20220826
IS  - 1878-8769 (Electronic)
IS  - 1878-8750 (Linking)
VI  - 163
DP  - 2022 Jul
TI  - Neck Disability at Presentation Influences Long-Term Clinical Improvement for 
      Neck Pain, Arm Pain, Disability, and Physical Function in Patients Undergoing 
      Anterior Cervical Discectomy and Fusion.
PG  - e663-e672
LID - S1878-8750(22)00508-3 [pii]
LID - 10.1016/j.wneu.2022.04.060 [doi]
AB  - OBJECTIVE: To compare perioperative characteristics, patient-reported outcome 
      measures (PROMs) and minimum clinically important difference (MCID) achievement 
      after anterior cervical discectomy and fusion (ACDF) in patients stratified by 
      preoperative neck disability. BACKGROUND: The Neck Disability Index (NDI) 
      assesses a patient's self-perceived neck disability and is often used to assess 
      the efficacy of cervical surgical intervention. Our study (a retrospective cohort 
      study) evaluates how preoperative severity of patient neck disability influences 
      postoperative clinical improvement after ACDF. METHODS: Primary, single-level, or 
      multilevel ACDF procedures were included. PROMs were administered at 
      preoperative/6 week/12 week/6 month/1 year/2 year time points and included 
      Patient-Reported Outcome Measurement Information System-Physical Function 
      (PROMIS-PF), visual analog scale (VAS) for neck and arm pain, NDI, and 12-Item 
      Short-Form (SF-12) Physical Composite Score (PCS). Patients were grouped 
      according to preoperative NDI <50 (mild to moderate neck disability) or NDI >/=50 
      (severe neck disability). Demographics/perioperative 
      characteristics/postoperative complications/mean PROMs/MCID achievement rates 
      were compared using chi(2) or Student t test. Postoperative improvement from 
      preoperative baseline within each cohort was assessed with paired-samples t test. 
      MCID achievement was determined by comparing DeltaPROMs with established thresholds. 
      RESULTS: A total of 225 patients were included, 150 NDI <50 and 75 NDI >/=50. The 
      NDI >/=50 cohort was significantly younger (P = 0.002). Cohorts did not differ for 
      spinal disease/operative duration/estimated blood loss/postoperative length of 
      stay/postoperative narcotic consumption/adjacent segment disease rate/1-year 
      arthrodesis rate/6-month pseudarthrosis rate. Postoperative VAS pain score on 
      postoperative day 0 and 1 was significantly increased in the NDI >/=50 cohort 
      (P < 0.048, all). Postoperative complication rates did not differ. All mean PROMs 
      differed at all time points (P < 0.043, all). The NDI <50 patient cohort 
      significantly improved from preoperative baseline for all PROMs and time points 
      except SF-12 PCS/Patient-Reported Outcome Measurement Information System-Physical 
      Function at 6 weeks. The NDI >/=50 cohort significantly improved for all PROMs and 
      time points except SF-12 PCS at 6 weeks. The NDI >/=50 cohort showed a greater 
      proportion achieving MCID for NDI at 6 weeks/2 years/overall (P < 0.037, all). 
      CONCLUSIONS: Both cohorts showed significant long-term clinical improvement for 
      neck pain/arm pain/physical function/neck disability, although patients with 
      severe preoperative neck disability reported inferior mean scores for these 
      outcomes at all time points.
CI  - Published by Elsevier Inc.
FAU - Jacob, Kevin C
AU  - Jacob KC
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Patel, Madhav R
AU  - Patel MR
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Ribot, Max A
AU  - Ribot MA
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Pawlowski, Hanna
AU  - Pawlowski H
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Prabhu, Michael C
AU  - Prabhu MC
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Vanjani, Nisheka N
AU  - Vanjani NN
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Collins, Andrew P
AU  - Collins AP
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA.
FAU - Singh, Kern
AU  - Singh K
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, USA. Electronic address: kern.singh@rushortho.com.
LA  - eng
PT  - Journal Article
DEP - 20220420
PL  - United States
TA  - World Neurosurg
JT  - World neurosurgery
JID - 101528275
SB  - IM
MH  - Arm/surgery
MH  - Cervical Vertebrae/surgery
MH  - Diskectomy/methods
MH  - Humans
MH  - *Neck Pain/surgery
MH  - Retrospective Studies
MH  - *Spinal Fusion/methods
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Neck disability
OT  - Patient-reported outcome measures
EDAT- 2022/04/24 06:00
MHDA- 2022/06/24 06:00
CRDT- 2022/04/23 20:10
PHST- 2022/02/23 00:00 [received]
PHST- 2022/04/13 00:00 [revised]
PHST- 2022/04/15 00:00 [accepted]
PHST- 2022/04/24 06:00 [pubmed]
PHST- 2022/06/24 06:00 [medline]
PHST- 2022/04/23 20:10 [entrez]
AID - S1878-8750(22)00508-3 [pii]
AID - 10.1016/j.wneu.2022.04.060 [doi]
PST - ppublish
SO  - World Neurosurg. 2022 Jul;163:e663-e672. doi: 10.1016/j.wneu.2022.04.060. Epub 
      2022 Apr 20.