PMID- 36418177
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230112
IS  - 2211-4599 (Print)
IS  - 2211-4599 (Electronic)
IS  - 2211-4599 (Linking)
VI  - 16
IP  - 6
DP  - 2022 Dec
TI  - Impact of Gender on Postsurgical Outcomes in Patients Undergoing Anterior 
      Cervical Discectomy and Fusion.
PG  - 991-1000
LID - 10.14444/8366 [doi]
AB  - BACKGROUND: Prior studies associate male gender with higher complication rates 
      following anterior cervical discectomy and fusion (ACDF), but none has 
      investigated gender influence on patient-reported outcome measures (PROMs) and 
      minimal clinically important difference (MCID) following single-level ACDF. 
      METHODS: Patients undergoing primary, single-level ACDF were divided into female 
      and male groups. Visual analog scale (VAS) neck/arm, Neck Disability Index (NDI), 
      12-item short form (SF-12) physical composite score (PCS), PROM information 
      system physical function (PROMIS-PF), and veterans RAND 12-item (VR-12) health 
      survey PCS were collected preoperatively and postoperatively. Simple linear 
      regression analysis evaluated the predictive capability of gender on PROMs. 
      Multiple regression analysis was performed to determine the effects of gender on 
      mean PROMs while accounting for insurance type. Established MCID values 
      determined achievement rates across PROMs. chi (2) analysis compared MCID 
      achievement by gender. RESULTS: A total of 179 women and 134 men were included. 
      Cohorts differed in insurance type, length of stay, and discharge day (P </= 0.017, 
      all). Women improved in PROMs at all timepoints (P </= 0.049, all) except SF-12 PCS 
      6 weeks and PROMIS-PF 6 weeks. Men improved in PROMs at all timepoints (P </= 
      0.042) except VAS arm 2 years, SF-12 PCS 6 weeks and 2 years, PROMIS-PF 6 weeks, 
      and VR-12 PCS 6 weeks. Women demonstrated higher SF-12 PCS (P = 0.043) and VR-12 
      PCS (P = 0.035) 2 years. Multiple regression determined that VAS neck and arm 
      from 6 weeks to 6 months, NDI from preoperative to 6 months, SF-12 PCS and VR-12 
      PCS from preoperative to 12 weeks, and PROMIS-PF preoperative, 6 weeks, and 6 
      months were significantly affected by gender and insurance status (P </= 0.031, 
      all). MCID achievement rate did not differ for any PROM between genders. 
      CONCLUSION: Women reported significantly higher long-term physical function 
      health (SF-12 PCS and VR-12 PCS) compared with men, while disability and pain did 
      not differ. Nevertheless, no significant differences in MCID achievement were 
      observed for any PROM studied. Gender does not appear to play a significant role 
      in clinically meaningful recovery following single-level ACDF. CLINICAL 
      RELEVANCE: Gender has little value in prognostication for determining clinically 
      meaningful recovery after single-level ACDF.
CI  - This manuscript is generously published free of charge by ISASS, the 
      International Society for the Advancement of Spine Surgery. Copyright (c) 2022 
      ISASS. To see more or order reprints or permissions, see http://ijssurgery.com.
FAU - Patel, Madhav R
AU  - Patel MR
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Jacob, Kevin C
AU  - Jacob KC
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Parsons, Alexander W
AU  - Parsons AW
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Vanjani, Nisheka N
AU  - Vanjani NN
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Prabhu, Michael C
AU  - Prabhu MC
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Pawlowski, Hanna
AU  - Pawlowski H
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 kern.singh@rushortho.com.
LA  - eng
PT  - Journal Article
DEP - 20221123
PL  - Netherlands
TA  - Int J Spine Surg
JT  - International journal of spine surgery
JID - 101579005
PMC - PMC9807048
OTO - NOTNLM
OT  - ACDF
OT  - MCID
OT  - PROM
OT  - gender
COIS- Declaration of Conflicting Interests: Kern Singh discloses that he has received 
      grants or contracts from the Cervical Spine Research Society; royalties or 
      licenses from RTI Surgical, Zimmer Biomet, Stryker, Lippincott Williams & 
      Wilkins, Theime, Jaypee Publishing, and Slack Publishing; consulting fees from 
      K2M and Zimmer Biomet; patents planned, issued, or pending with TDi LLC; and 
      leadership or fiduciary role on Vitals 5 LLC, TDi LLC, Minimally Invasive Spine 
      Study Group, Contemporary Spine Surgery, Orthopedics Today, and Vertebral 
      Columns. The remaining authors have nothing to report.
EDAT- 2022/11/24 06:00
MHDA- 2022/11/24 06:01
PMCR- 2022/11/23
CRDT- 2022/11/23 21:41
PHST- 2021/12/05 00:00 [revised]
PHST- 2022/11/24 06:00 [pubmed]
PHST- 2022/11/24 06:01 [medline]
PHST- 2022/11/23 21:41 [entrez]
PHST- 2022/11/23 00:00 [pmc-release]
AID - 8366 [pii]
AID - IJSSURGERY-D-21-00406 [pii]
AID - 10.14444/8366 [doi]
PST - ppublish
SO  - Int J Spine Surg. 2022 Dec;16(6):991-1000. doi: 10.14444/8366. Epub 2022 Nov 23.