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Research ArticleCervical Spine

Baseline Neck Disability Index and Patient-Reported Outcomes Measurement Information System Physical Function Predict Postoperative Return to Normal in Cervical Spine Surgery

Gregory S. Kazarian, Michael E. Steinhaus, Sravisht Iyer, Drake LeBrun, Robert Cecere, Takashi Hirase, Francis Lovecchio, Todd J. Albert, Darren Lebl, Darren Huang, Harvinder Sandhu, Bernard Rawlins, Frank Schwab, Virginie Lafage and Han Jo Kim
International Journal of Spine Surgery October 2024, 8653; DOI: https://doi.org/10.14444/8653
Gregory S. Kazarian
1 Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
MD
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Michael E. Steinhaus
1 Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
MD
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Sravisht Iyer
1 Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
MD
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Drake LeBrun
1 Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
MD
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Robert Cecere
1 Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
BS
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Takashi Hirase
1 Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
MD
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Francis Lovecchio
1 Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
MD
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Todd J. Albert
1 Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
MD
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Darren Lebl
1 Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
MD
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Darren Huang
1 Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
MD
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Harvinder Sandhu
1 Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
MD
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Bernard Rawlins
1 Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
MD
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Frank Schwab
1 Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
MD
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Virginie Lafage
1 Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
PhD
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Han Jo Kim
1 Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
MD
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  • For correspondence: KimH@HSS.edu
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    Figure 1

    Proportion of patients meeting NDI PASS shown as a function of preoperative NDI. Differences between these groups were statistically significant (P = 0.005). NDI, Neck Disability Index; PASS, patient acceptable symptom state.

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    Figure 2

    Proportion of patients attaining the normative means (≥50) for PROMIS PF shown as a function of preoperative PROMIS PF quintile. Differences between these groups were statistically significant (P = 0.035). PROMIS PF, Patient-Reported Outcomes Measurement Information System Physical Function.

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    Figure 3

    Proportion of patients attaining the normative means (≤50) for PROMIS PI shown as a function of preoperative PROMIS PI quintile. Differences between these groups were not statistically significant. PROMIS PI, Patient-Reported Outcomes Measurement Information System Pain Interference.

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    Table 1

    Association between preoperative outcomes and postoperative clinical benefit.

    Surgery IndicationPROMIS PFPROMIS PINDI
    PreoperativePostoperative ImprovementPreoperativePostoperative ImprovementPreoperativePostoperative Improvement
    Radiculopathy39.2 (8.1)5.2 (8.0)60.4 (7.8)−8.9 (10.8)29.4 (22.0)13.4 (17.8)
    Myelopathy41.7 (7.4)9.0 (9.4)61.9 (6.0)−10.3 (9.5)39.2 (2.2)22.2 (17.6)
    Myeloradiculopathy43.0 (8.4)5.6 (7.2)59.9 (7.3)−6.9 (9.1)31.6 (19.5)14.4 (14.5)
    • Abbreviations: NDI, Neck Disability Index; PROMIS PF, Patient-Reported Outcomes Measurement Information System Physical Function; PROMIS PI, Patient-Reported Outcomes Measurement Information System Pain Interference.

    • Note: For Neck Disability Index, postoperative improvements reflect a decrease in score, as lower scores reflect lower disability.

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    Table 2

    Association between preoperative diagnosis and outcome.

    OutcomeOR95% CI P
    Overall
     NDI0.960.94, 0.98<0.001
     PROMIS PI1.040.99, 1.090.144
     PROMIS PF1.11.04, 1.16<0.001
    Radiculopathy
     NDI0.960.92, 0.990.022
     PROMIS PI1.030.95, 1.120.491
     PROMIS PF1.141.01, 1.290.033
    Myelopathy
     NDI0.980.94, 1.020.35
     PROMIS PI1.060.96, 1.180.262
     PROMIS PF1.030.95, 1.110.515
    • Abbreviations: NDI, Neck Disability Index; PASS, patient acceptable symptom state; PF, Physical Function; PI, Pain Interference; PROMIS, Patient-Reported Outcomes Measurement Information System.

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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Baseline Neck Disability Index and Patient-Reported Outcomes Measurement Information System Physical Function Predict Postoperative Return to Normal in Cervical Spine Surgery
Gregory S. Kazarian, Michael E. Steinhaus, Sravisht Iyer, Drake LeBrun, Robert Cecere, Takashi Hirase, Francis Lovecchio, Todd J. Albert, Darren Lebl, Darren Huang, Harvinder Sandhu, Bernard Rawlins, Frank Schwab, Virginie Lafage, Han Jo Kim
International Journal of Spine Surgery Oct 2024, 8653; DOI: 10.14444/8653

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Baseline Neck Disability Index and Patient-Reported Outcomes Measurement Information System Physical Function Predict Postoperative Return to Normal in Cervical Spine Surgery
Gregory S. Kazarian, Michael E. Steinhaus, Sravisht Iyer, Drake LeBrun, Robert Cecere, Takashi Hirase, Francis Lovecchio, Todd J. Albert, Darren Lebl, Darren Huang, Harvinder Sandhu, Bernard Rawlins, Frank Schwab, Virginie Lafage, Han Jo Kim
International Journal of Spine Surgery Oct 2024, 8653; DOI: 10.14444/8653
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