Impact of Preoperative Symptom Duration on Patient-Reported Outcomes Following Cervical Disc Replacement for Cervical Radiculopathy
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Impact of Preoperative Symptom Duration on Patient-Reported Outcomes Following Cervical Disc Replacement for Cervical Radiculopathy. / Mai, Eric; Kim, Eric; Kaidi, Austin; Subramanian, Tejas; Simon, Chad Z; Asada, Tomoyuki; Kwas, Cole; Zhang, Joshua; Araghi, Kasra; Singh, Nishtha; Tuma, Olivia; Korsun, Maximilian; Allen, Myles; Heuer, Annika; Sheha, Evan D; Dowdell, James; Huang, Russel C; Albert, Todd J; Qureshi, Sheeraz A; Iyer, Sravisht.
In: SPINE, Vol. 49, No. 18, 15.09.2024, p. 1251-1258.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Impact of Preoperative Symptom Duration on Patient-Reported Outcomes Following Cervical Disc Replacement for Cervical Radiculopathy
AU - Mai, Eric
AU - Kim, Eric
AU - Kaidi, Austin
AU - Subramanian, Tejas
AU - Simon, Chad Z
AU - Asada, Tomoyuki
AU - Kwas, Cole
AU - Zhang, Joshua
AU - Araghi, Kasra
AU - Singh, Nishtha
AU - Tuma, Olivia
AU - Korsun, Maximilian
AU - Allen, Myles
AU - Heuer, Annika
AU - Sheha, Evan D
AU - Dowdell, James
AU - Huang, Russel C
AU - Albert, Todd J
AU - Qureshi, Sheeraz A
AU - Iyer, Sravisht
N1 - Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2024/9/15
Y1 - 2024/9/15
N2 - STUDY DESIGN: Retrospective review of prospectively collected data.OBJECTIVE: To determine the impact of preoperative symptom duration on postoperative functional outcomes after cervical disc replacement (CDR) for radiculopathy.SUMMARY OF BACKGROUND DATA: CDR has emerged as a reliable and efficacious treatment option for degenerative cervical spine pathologies. The relationship between preoperative symptom duration and outcomes after CDR is not well established.METHODS: Patients with radiculopathy without myelopathy who underwent primary 1- or 2-level CDRs were included and divided into shorter (<6 mo) and prolonged (≥6 mo) cohorts based on preoperative symptom duration. Patient-reported outcome measures (PROMs) included neck disability index (NDI), visual analog scale (VAS) neck and arm. Changes in PROM scores and minimal clinically important difference (MCID) rates were calculated. Analyses were conducted on the early (within 3 mo) and late (6 mo-2 y) postoperative periods.RESULTS: A total of 201 patients (43.6±8.7 y, 33.3% female) were included. In both early and late postoperative periods, the shorter preoperative symptom duration cohort experienced significantly greater change from preoperative PROM scores compared with the prolonged symptom duration cohort for NDI, VAS-Neck, and VAS-Arm. The shorter symptom duration cohort achieved MCID in the early postoperative period at a significantly higher rate for NDI (78.9% vs. 54.9%, P =0.001), VAS-Neck (87.0% vs. 56.0%, P <0.001), and VAS-Arm (90.5% vs. 70.7%, P =0.002). Prolonged preoperative symptom duration (≥6 mo) was identified as an independent risk factor for failure to achieve MCID at the latest timepoint for NDI (OR: 2.9, 95% CI: 1.2-6.9, P =0.016), VAS-Neck (OR: 9.8, 95% CI: 3.7-26.0, P <0.001), and VAS-Arm (OR: 7.5, 95% CI: 2.5-22.5, P <0.001).CONCLUSIONS: Our study demonstrates improved patient-reported outcomes for those with shorter preoperative symptom duration undergoing CDR for radiculopathy, suggesting delayed surgical intervention may result in poorer outcomes and greater postoperative disability.LEVEL OF EVIDENCE: Level III.
AB - STUDY DESIGN: Retrospective review of prospectively collected data.OBJECTIVE: To determine the impact of preoperative symptom duration on postoperative functional outcomes after cervical disc replacement (CDR) for radiculopathy.SUMMARY OF BACKGROUND DATA: CDR has emerged as a reliable and efficacious treatment option for degenerative cervical spine pathologies. The relationship between preoperative symptom duration and outcomes after CDR is not well established.METHODS: Patients with radiculopathy without myelopathy who underwent primary 1- or 2-level CDRs were included and divided into shorter (<6 mo) and prolonged (≥6 mo) cohorts based on preoperative symptom duration. Patient-reported outcome measures (PROMs) included neck disability index (NDI), visual analog scale (VAS) neck and arm. Changes in PROM scores and minimal clinically important difference (MCID) rates were calculated. Analyses were conducted on the early (within 3 mo) and late (6 mo-2 y) postoperative periods.RESULTS: A total of 201 patients (43.6±8.7 y, 33.3% female) were included. In both early and late postoperative periods, the shorter preoperative symptom duration cohort experienced significantly greater change from preoperative PROM scores compared with the prolonged symptom duration cohort for NDI, VAS-Neck, and VAS-Arm. The shorter symptom duration cohort achieved MCID in the early postoperative period at a significantly higher rate for NDI (78.9% vs. 54.9%, P =0.001), VAS-Neck (87.0% vs. 56.0%, P <0.001), and VAS-Arm (90.5% vs. 70.7%, P =0.002). Prolonged preoperative symptom duration (≥6 mo) was identified as an independent risk factor for failure to achieve MCID at the latest timepoint for NDI (OR: 2.9, 95% CI: 1.2-6.9, P =0.016), VAS-Neck (OR: 9.8, 95% CI: 3.7-26.0, P <0.001), and VAS-Arm (OR: 7.5, 95% CI: 2.5-22.5, P <0.001).CONCLUSIONS: Our study demonstrates improved patient-reported outcomes for those with shorter preoperative symptom duration undergoing CDR for radiculopathy, suggesting delayed surgical intervention may result in poorer outcomes and greater postoperative disability.LEVEL OF EVIDENCE: Level III.
U2 - 10.1097/BRS.0000000000005020
DO - 10.1097/BRS.0000000000005020
M3 - SCORING: Journal article
C2 - 38679871
VL - 49
SP - 1251
EP - 1258
JO - SPINE
JF - SPINE
SN - 0362-2436
IS - 18
ER -
