RT Journal Article
SR Electronic
T1 How Do Patients With Predominant Neck Pain Improve After Anterior Cervical Discectomy and Fusion for Cervical Radiculopathy?
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 240
OP 246
DO 10.14444/8212
VO 16
IS 2
A1 Srikanth N. Divi
A1 Dhruv K.C. Goyal
A1 Barrett I. Woods
A1 Kristen J. Nicholson
A1 Harold I. Salmons
A1 Matthew S. Galetta
A1 Mahir A. Qureshi
A1 Meghan E. Lam
A1 Andrew L. DiMatteo
A1 D. Greg Anderson
A1 Mark F. Kurd
A1 Jeffrey A. Rihn
A1 Ian D. Kaye
A1 Christopher K. Kepler
A1 Alan S. Hilibrand
A1 Alexander R. Vaccaro
A1 Kristen E. Radcliff
A1 Gregory D. Schroeder
YR 2022
UL http://ijssurgery.com//content/16/2/240.abstract
AB Background The presence of predominant pain in the arm vs the neck as a predictor of postoperative outcomes after anterior cervical discectomy and fusion (ACDF) has been seldom reported; therefore, the purpose of this study was to determine whether patients with predominant neck pain improve after surgery compared to patients with predominant arm pain or those with mixed symptoms in patients undergoing ACDF for radiculopathy.Methods A retrospective cohort study was conducted on patients who underwent ACDF at a single center from 2016 to 2018. Patients were split into groups based on preoperative neck and arm pain scores: neck (N) pain dominant group (visual analog scale [VAS] neck ≥ VAS arm by 1.0 point); neutral group (VAS neck < VAS arm by 1.0 point); or arm (A) pain dominant group (VAS arm ≥ VAS neck by 1.0 point), using a threshold difference of 1.0 point. Subsequently, individuals were substratified into 2 groups based on the arm to neck pain ratio (ANR): non-arm pain dominant defined as ANR ≤1.0 and arm pain dominant (APD) defined as ANR >1.0. Patient-reported outcome measurements including Neck Disability Index (NDI), Physical Component Score-12, and Mental Component Score (MCS-12) were compared between groups.Results No significant differences between groups when stratifying patients using a threshold difference of 1.0 point. When stratifying patients using the ANR, those in the APD group had significantly higher postoperative MCS-12 (P = 0.008) and NDI (P = 0.011) scores. In addition, the APD group showed a greater magnitude of improvement for MCS-12 and NDI scores (P = 0.043 and P = 0.038, respectively). Multiple linear regression showed that the A and the APD groups were both independent predictors of improvement in NDI.Conclusion Patients with dominant arm pain showed significantly greater improvement in terms of MCS-12 and NDI scores compared to patients with dominant neck pain.Clinical Relevance To compare the impact of ACDF on arm and neck pain in the context of cervical radiculopathy using patient-reported outcome measures as an objective measurement.Level of Evidence 3.