PMID- 38241683
OWN - NLM
STAT- MEDLINE
DCOM- 20240403
LR  - 20240403
IS  - 1547-5646 (Electronic)
IS  - 1547-5646 (Linking)
VI  - 40
IP  - 4
DP  - 2024 Apr 1
TI  - Does the number of social factors affect long-term patient-reported outcomes and 
      satisfaction in those with cervical myelopathy? A QOD study.
PG  - 428-438
LID - 10.3171/2023.11.SPINE23127 [doi]
AB  - OBJECTIVE: It is not clear whether there is an additive effect of social factors 
      in keeping patients with cervical spondylotic myelopathy (CSM) from achieving 
      both a minimum clinically important difference (MCID) in outcomes and 
      satisfaction after surgery. The aim of this study was to explore the effect of 
      multiple social factors on postoperative outcomes and satisfaction. METHODS: This 
      was a multiinstitutional, retrospective study of the prospective Quality Outcomes 
      Database (QOD) CSM cohort, which included patients aged 18 years or older who 
      were diagnosed with primary CSM and underwent operative management. Social 
      factors included race (White vs non-White), education (high school or below vs 
      above), employment (employed vs not), and insurance (private vs nonprivate). 
      Patients were considered to have improved from surgery if the following criteria 
      were met: 1) they reported a score of 1 or 2 on the North American Spine Society 
      index, and 2) they met the MCID in patient-reported outcomes (i.e., visual analog 
      scale [VAS] neck and arm pain, Neck Disability Index [NDI], and EuroQol-5D 
      [EQ-5D]). RESULTS: Of the 1141 patients included in the study, 205 (18.0%) had 0, 
      347 (30.4%) had 1, 334 (29.3%) had 2, and 255 (22.3%) had 3 social factors. The 
      24-month follow-up rate was > 80% for all patient-reported outcomes. After 
      adjusting for all relevant covariates (p < 0.02), patients with 1 or more social 
      factors were less likely to improve from surgery in all measured outcomes 
      including VAS neck pain (OR 0.90, 95% CI 0.83-0.99) and arm pain (OR 0.88, 95% CI 
      0.80-0.96); NDI (OR 0.90, 95% CI 0.83-0.98); and EQ-5D (OR 0.90, 95% CI 
      0.83-0.97) (all p < 0.05) compared to those without any social factors. Patients 
      with 2 social factors (outcomes: neck pain OR 0.86, arm pain OR 0.81, NDI OR 
      0.84, EQ-5D OR 0.81; all p < 0.05) or 3 social factors (outcomes: neck pain OR 
      0.84, arm pain OR 0.84, NDI OR 0.84, EQ-5D OR 0.84; all p < 0.05) were more 
      likely to fare worse in all outcomes compared to those with only 1 social factor. 
      CONCLUSIONS: Compared to those without any social factors, patients who had at 
      least 1 social factor were less likely to achieve MCID and feel satisfied after 
      surgery. The effect of social factors is additive in that patients with a higher 
      number of factors are less likely to improve compared to those with only 1 social 
      factor.
FAU - Park, Christine
AU  - Park C
AD  - 1Department of Neurosurgery, Duke University, Durham, North Carolina.
FAU - Shaffrey, Christopher I
AU  - Shaffrey CI
AD  - 1Department of Neurosurgery, Duke University, Durham, North Carolina.
FAU - Than, Khoi D
AU  - Than KD
AD  - 1Department of Neurosurgery, Duke University, Durham, North Carolina.
FAU - Bisson, Erica F
AU  - Bisson EF
AD  - 2Department of Neurosurgery, University of Utah, Salt Lake City, Utah.
FAU - Sherrod, Brandon A
AU  - Sherrod BA
AD  - 2Department of Neurosurgery, University of Utah, Salt Lake City, Utah.
FAU - Asher, Anthony L
AU  - Asher AL
AD  - 3Neuroscience Institute, Carolinas Healthcare System and Carolina Neurosurgery & 
      Spine Associates, Charlotte, North Carolina.
FAU - Coric, Domagoj
AU  - Coric D
AD  - 3Neuroscience Institute, Carolinas Healthcare System and Carolina Neurosurgery & 
      Spine Associates, Charlotte, North Carolina.
FAU - Potts, Eric A
AU  - Potts EA
AD  - 4Goodman Campbell Brain and Spine, Indianapolis, Indiana.
FAU - Foley, Kevin T
AU  - Foley KT
AD  - 5Department of Neurosurgery, Semmes Murphey Neurologic and Spine Institute, 
      Memphis, Tennessee.
FAU - Wang, Michael Y
AU  - Wang MY
AD  - 6Department of Neurosurgery, University of Miami, Florida.
FAU - Fu, Kai-Ming
AU  - Fu KM
AD  - 7Department of Neurosurgery, Weill Cornell Medical Center, New York, New York.
FAU - Virk, Michael S
AU  - Virk MS
AD  - 7Department of Neurosurgery, Weill Cornell Medical Center, New York, New York.
FAU - Knightly, John J
AU  - Knightly JJ
AD  - 8Atlantic Neurosurgical Specialists, Morristown, New Jersey.
FAU - Meyer, Scott
AU  - Meyer S
AD  - 8Atlantic Neurosurgical Specialists, Morristown, New Jersey.
FAU - Park, Paul
AU  - Park P
AD  - 9Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan.
FAU - Upadhyaya, Cheerag
AU  - Upadhyaya C
AD  - 10Marion Bloch Neuroscience Institute, Saint Luke's Health System, Kansas City, 
      Missouri.
FAU - Shaffrey, Mark E
AU  - Shaffrey ME
AD  - 11Department of Neurosurgery, University of Virginia, Charlottesville, Virginia.
FAU - Buchholz, Avery L
AU  - Buchholz AL
AD  - 11Department of Neurosurgery, University of Virginia, Charlottesville, Virginia.
FAU - Tumialan, Luis M
AU  - Tumialan LM
AD  - 12Barrow Neurological Institute, Phoenix, Arizona.
FAU - Turner, Jay D
AU  - Turner JD
AD  - 12Barrow Neurological Institute, Phoenix, Arizona.
FAU - Agarwal, Nitin
AU  - Agarwal N
AD  - 13Department of Neurosurgery, Washington University in St. Louis, Missouri.
FAU - Chan, Andrew K
AU  - Chan AK
AD  - 14Department of Neurological Surgery, Columbia University Vagelos College of 
      Physicians and Surgeons, The Och Spine Hospital at NewYork-Presbyterian, New 
      York, New York.
FAU - Chou, Dean
AU  - Chou D
AD  - 14Department of Neurological Surgery, Columbia University Vagelos College of 
      Physicians and Surgeons, The Och Spine Hospital at NewYork-Presbyterian, New 
      York, New York.
FAU - Chaudhry, Nauman S
AU  - Chaudhry NS
AD  - 15Department of Neurosurgery, University of South Florida, Tampa, Florida.
FAU - Haid, Regis W
AU  - Haid RW
AD  - 16Atlanta Brain and Spine Care, Atlanta, Georgia.
FAU - Mummaneni, Praveen V
AU  - Mummaneni PV
AD  - 17Department of Neurosurgery, University of California, San Francisco, 
      California; and.
FAU - Michalopoulos, Georgios D
AU  - Michalopoulos GD
AD  - 18Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota.
FAU - Bydon, Mohamad
AU  - Bydon M
AD  - 18Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota.
FAU - Gottfried, Oren N
AU  - Gottfried ON
AD  - 1Department of Neurosurgery, Duke University, Durham, North Carolina.
LA  - eng
PT  - Journal Article
DEP - 20240119
PL  - United States
TA  - J Neurosurg Spine
JT  - Journal of neurosurgery. Spine
JID - 101223545
SB  - IM
MH  - Humans
MH  - *Neck Pain/surgery
MH  - Treatment Outcome
MH  - Social Factors
MH  - Patient Satisfaction
MH  - Retrospective Studies
MH  - Prospective Studies
MH  - Cervical Vertebrae/surgery
MH  - *Spinal Cord Diseases/surgery
MH  - Patient Reported Outcome Measures
MH  - Personal Satisfaction
OTO - NOTNLM
OT  - Quality Outcomes Database
OT  - cervical spondylotic myelopathy
OT  - pain
OT  - patient-reported outcomes
OT  - satisfaction
OT  - social factors
EDAT- 2024/01/19 18:42
MHDA- 2024/04/03 06:44
CRDT- 2024/01/19 16:53
PHST- 2023/02/01 00:00 [received]
PHST- 2023/11/16 00:00 [accepted]
PHST- 2024/04/03 06:44 [medline]
PHST- 2024/01/19 18:42 [pubmed]
PHST- 2024/01/19 16:53 [entrez]
AID - 10.3171/2023.11.SPINE23127 [doi]
PST - epublish
SO  - J Neurosurg Spine. 2024 Jan 19;40(4):428-438. doi: 10.3171/2023.11.SPINE23127. 
      Print 2024 Apr 1.