PMID- 37230245
OWN - NLM
STAT- MEDLINE
DCOM- 20230809
LR  - 20230809
IS  - 1878-8769 (Electronic)
IS  - 1878-8750 (Linking)
VI  - 176
DP  - 2023 Aug
TI  - Differences in Time to Achieve Minimum Clinically Important Difference Between 
      Patients Undergoing Anterior Cervical Discectomy and Fusion and Cervical Disc 
      Replacement.
PG  - e337-e344
LID - S1878-8750(23)00697-6 [pii]
LID - 10.1016/j.wneu.2023.05.059 [doi]
AB  - OBJECTIVE: To compare patients undergoing anterior cervical discectomy and fusion 
      (ACDF) versus cervical disc replacement (CDR) for time to minimum clinically 
      important difference (MCID) achievement and predictors of delayed MCID 
      achievement for the patient-reported outcomes (PROs), Patient-Reported Outcomes 
      Measurement Information System Physical Function, Neck Disability Index, Visual 
      Analog Scale (VAS) neck, and VAS arm. METHODS: PROs of patients undergoing ACDF 
      or CDR were collected preoperatively and postoperatively at 
      6-week/12-week/6-month/1-year/2-year periods. MCID achievement was calculated 
      through comparison of changes in Patient-Reported Outcomes Measurement to 
      previously established values in literature. Time to MCID achievement and 
      predictors for delayed MCID achievement were determined through Kaplan-Meier 
      survival analysis and multivariable Cox regression, respectively. RESULTS: One 
      hundred ninety-seven patients were identified, with 118 and 79 undergoing ACDF 
      and CDR, respectively. Kaplan-Meier survival analysis demonstrated faster time to 
      achieve MCID for CDR patients in Patient-Reported Outcomes Measurement 
      Information System Physical Function (P = 0.006). Early predictors of MCID 
      achievement through Cox regression were CDR procedure, Asian ethnicity, elevated 
      preoperative PROs of VAS neck and VAS arm (hazard ratio, 1.16-7.28). Workers' 
      compensation was a late predictor of MCID achievement (hazard ratio, 0.15). 
      CONCLUSIONS: Most patients achieved MCID in physical function, disability, and 
      back pain outcomes within 2 years of surgery. Patients undergoing CDR achieved 
      MCID faster in physical function. Early predictors of MCID achievement were CDR 
      procedure, Asian ethnicity, and elevated preoperative PROs of pain outcomes. 
      Workers' compensation was a late predictor. These findings may be helpful in 
      managing patient expectations.
CI  - Copyright (c) 2023 Elsevier Inc. All rights reserved.
FAU - Federico, Vincent P
AU  - Federico VP
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Nie, James W
AU  - Nie JW
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Hartman, Timothy J
AU  - Hartman TJ
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Zheng, Eileen
AU  - Zheng E
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Oyetayo, Omolabake O
AU  - Oyetayo OO
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - MacGregor, Keith R
AU  - MacGregor KR
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Massel, Dustin H
AU  - Massel DH
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Sayari, Arash J
AU  - Sayari AJ
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. Electronic address: kern.singh@rushortho.com.
LA  - eng
PT  - Journal Article
DEP - 20230523
PL  - United States
TA  - World Neurosurg
JT  - World neurosurgery
JID - 101528275
SB  - IM
MH  - Humans
MH  - Treatment Outcome
MH  - *Cervical Vertebrae/surgery
MH  - Disability Evaluation
MH  - *Spinal Fusion/methods
MH  - Diskectomy/methods
OTO - NOTNLM
OT  - Anterior cervical discectomy and fusion
OT  - Cervical disc replacement
OT  - Minimum clinically important difference
OT  - Patient-reported outcomes
EDAT- 2023/05/26 01:05
MHDA- 2023/08/09 06:43
CRDT- 2023/05/25 19:25
PHST- 2023/04/04 00:00 [received]
PHST- 2023/05/15 00:00 [revised]
PHST- 2023/05/16 00:00 [accepted]
PHST- 2023/08/09 06:43 [medline]
PHST- 2023/05/26 01:05 [pubmed]
PHST- 2023/05/25 19:25 [entrez]
AID - S1878-8750(23)00697-6 [pii]
AID - 10.1016/j.wneu.2023.05.059 [doi]
PST - ppublish
SO  - World Neurosurg. 2023 Aug;176:e337-e344. doi: 10.1016/j.wneu.2023.05.059. Epub 
      2023 May 23.