PMID- 38245809 OWN - NLM STAT- Publisher LR - 20240121 IS - 2380-0194 (Electronic) IS - 2380-0186 (Linking) DP - 2024 Jan 9 TI - Coexisting Lower Back Pain in Patients With Cervical Myelopathy. LID - 10.1097/BSD.0000000000001572 [doi] AB - STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The aim of the present study is to investigate the coexisting lower back pain (LBP) in patients with cervical myelopathy and to evaluate changes in LBP after cervical spine surgery. SUMMARY OF BACKGROUND DATA: Only a few studies with a small number of participants have evaluated the association between cervical myelopathy surgery and postoperative improvement in LBP. METHODS: Patients who underwent primary cervical decompression surgery with or without fusion for myelopathy and completed preoperative and 1-year postoperative questionnaires were reviewed using a prospectively collected database involving 9 tertiary referral hospitals. The questionnaires included the patient-reported Japanese Orthopaedic Association (PRO-JOA) score and Numerical Rating Scales (NRS). The minimum clinically important difference (MCID) for NRS-LBP was defined as >30% improvement from baseline. Patient demographics, characteristics, and PRO-JOA score were compared between patients with and without concurrent LBP, and the contributor to achieving the MCID for LBP was analyzed using logistic regression analysis. RESULTS: A total of 786 consecutive patients with cervical myelopathy were included, of which 525 (67%) presented with concurrent LBP. LBP was associated with a higher body mass index (P<0.001) and worse preoperative PRO-JOA score (P<0.001). Among the 525 patients with concurrent LBP, the mean postoperative NRS-LBP significantly improved from 4.5+/-2.4 to 3.4+/-2.7 (P<0.01) postoperatively, with 248 (47%) patients reaching the MCID cutoff. Patients with a PRO-JOA recovery rate >50% were more likely to achieve MCID compared with those with a recovery rate <0% (adjusted odd ratio 4.02, P<0.001). CONCLUSIONS: More than 50% of patients with myelopathy reported improvement in LBP after cervical spine surgery, and 47% achieved the MCID for LBP, which was positively correlated with a better PRO-JOA recovery rate. Treating cervical myelopathy in patients with concomitant LBP may be sufficient to mitigate concomitant LBP. LEVEL OF EVIDENCE: Level Ⅲ. CI - Copyright (c) 2024 Wolters Kluwer Health, Inc. All rights reserved. FAU - Nakarai, Hiroyuki AU - Nakarai H AD - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY. AD - University of Tokyo Spine Group (UTSG). FAU - Kato, So AU - Kato S AD - University of Tokyo Spine Group (UTSG). AD - Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo. FAU - Hirao, Yujiro AU - Hirao Y AD - Department of Orthopaedic Surgery, Takashimadaira Chuo General Hospital, Takashimadaira, Itabashi. FAU - Maayan, Omri AU - Maayan O AD - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY. FAU - Kawamura, Naohiro AU - Kawamura N AD - University of Tokyo Spine Group (UTSG). AD - Department of Spine and Orthopedic Surgery, Japanese Red Cross Medical Center, Shibuya-Ku, Tokyo. FAU - Higashikawa, Akiro AU - Higashikawa A AD - University of Tokyo Spine Group (UTSG). AD - Department of Orthopedic Surgery, Kanto Rosai Hospital, Nakahara-Ku, Kawasaki. FAU - Takeshita, Yujiro AU - Takeshita Y AD - University of Tokyo Spine Group (UTSG). AD - Department of Orthopedic Surgery, Yokohama Rosai Hospital, Yokohama City, Kanagawa. FAU - Ono, Takashi AU - Ono T AD - University of Tokyo Spine Group (UTSG). AD - Department of Spinal Surgery, Japan Community Health-care Organization Tokyo Shinjuku Medical Center, Shinjuku-Ku, Tokyo. FAU - Fukushima, Masayoshi AU - Fukushima M AD - Spine center, Toranomon Hospital, Minato-Ku, Tokyo. FAU - Hara, Nobuhiro AU - Hara N AD - University of Tokyo Spine Group (UTSG). AD - Department of Orthopedic Surgery, Japanese Red Cross Musashino Hospital, Musashino City, Tokyo. FAU - Azuma, Seiichi AU - Azuma S AD - University of Tokyo Spine Group (UTSG). AD - Department of Orthopedic Surgery, Saitama Red Cross Hospital, Saitama City, Saitama. FAU - Iwai, Hiroki AU - Iwai H AD - University of Tokyo Spine Group (UTSG). AD - Department of Orthopaedic Surgery, Inanami Spine and Joint Hospital, Shinagawa-ku, Tokyo. FAU - Taniguchi, Yuki AU - Taniguchi Y AD - University of Tokyo Spine Group (UTSG). AD - Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo. FAU - Matsubayashi, Yoshitaka AU - Matsubayashi Y AD - University of Tokyo Spine Group (UTSG). AD - Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo. FAU - Takeshita, Katsushi AU - Takeshita K AD - Department of Orthopaedic, Jichi Medical University, Shimotsuke, Tochigi, Japan. FAU - Tanaka, Sakae AU - Tanaka S AD - Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo. FAU - Oshima, Yasushi AU - Oshima Y AD - University of Tokyo Spine Group (UTSG). AD - Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo. LA - eng PT - Journal Article DEP - 20240109 PL - United States TA - Clin Spine Surg JT - Clinical spine surgery JID - 101675083 SB - IM COIS- The authors declare no conflict of interest. EDAT- 2024/01/21 06:41 MHDA- 2024/01/21 06:41 CRDT- 2024/01/21 00:02 PHST- 2023/07/27 00:00 [received] PHST- 2023/11/29 00:00 [accepted] PHST- 2024/01/21 06:41 [medline] PHST- 2024/01/21 06:41 [pubmed] PHST- 2024/01/21 00:02 [entrez] AID - 01933606-990000000-00254 [pii] AID - 10.1097/BSD.0000000000001572 [doi] PST - aheadofprint SO - Clin Spine Surg. 2024 Jan 9. doi: 10.1097/BSD.0000000000001572.