Study Design: 

Retrospective cohort.

Objective: 

The aim was to determine how neck pain and disability improve following anterior cervical discectomy and fusion among patients with myeloradiculopathy.

Summary of Background Data: 

Neck pain and disability have traditionally been assessed using the neck disability index (NDI) and visual analog scale (VAS). Few studies have investigated how neck pain/disability improve differently among patients with symptoms of both myelopathy and radiculopathy.

Methods: 

Patients were identified through retrospective review of a prospective surgical database from 2013 to 2020. Patient-reported outcome measures (PROMs) collected included VAS neck and arm, NDI, 12-Item Short Form physical composite score (SF-12 PCS), Patient-Reported Outcomes Measurement Information System physical function (PROMIS PF), and Patient Health Questionnaire 9 (PHQ-9). PROMs were collected preoperatively and up to 1-year postoperatively. Patients were categorized by preoperative symptom severity: high VAS arm (>7); high NDI (>55); high VAS arm and NDI; and moderate symptoms. Linear and logistic regression evaluated the impact of preoperative symptom severity on PROM scores and achievement of minimum clinically important difference (MCID), respectively.

Results: 

A total of 187 patients were included, 98 with neither high VAS arm nor NDI (moderate group), 14 with high NDI, 46 with high VAS arm, and 29 with high NDI and VAS arm. Postoperatively, greater symptom severity was a significant predictor of VAS neck (all timepoints; P≤0.002, all), VAS arm (6 weeks; P=0.007), NDI (6 weeks to 6 months; P<0.001, all), SF-12 PCS (6 months; P=0.004), PROMIS PF (6 weeks; P=0.007), and PHQ-9 (6 weeks to 6 months; P<0.001, all). Mean postoperative improvement was different among the four severity groups for VAS arm, NDI, and VAS neck (except for 1-year) (P≤0.002, all). Overall MCID achievement rates were significantly greater among higher symptom severity groups across VAS arm and NDI (P≤0.003, both).

Conclusion: 

PROM improvement and MCID achievement for NDI, VAS neck, and VAS arm differed based on symptom severity.

中文翻译：

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颈前路椎间盘切除融合术后脊髓神经根病患者术前严重程度对术后改善的影响

学习规划： 

回顾性队列。

客观的： 

目的是确定脊髓神经根病患者在颈前路椎间盘切除术和融合术后颈部疼痛和残疾如何改善。

背景数据摘要： 

传统上使用颈部残疾指数（NDI）和视觉模拟量表（VAS）来评估颈部疼痛和残疾。很少有研究调查同时患有脊髓病和神经根病症状的患者颈部疼痛/残疾的改善情况有何不同。

方法： 

通过对 2013 年至 2020 年前瞻性手术数据库进行回顾性审查来确定患者。收集的患者报告结果测量(PROM) 包括 VAS 颈部和手臂、NDI、12 项简短身体综合评分 (SF-12 PCS)、患者-报告结果测量信息系统身体功能 (PROMIS PF) 和患者健康问卷 9 (PHQ-9)。PROM 是在术前和术后 1 年内收集的。根据术前症状严重程度对患者进行分类：高 VAS 组（>7）；高 NDI (>55)；高 VAS 臂和 NDI；和中度症状。线性和逻辑回归分别评估了术前症状严重程度对 PROM 评分和实现最小临床重要差异 (MCID) 的影响。

结果： 

总共纳入 187 例患者，其中 98 例既没有高 VAS 组也没有 NDI（中度组），14 例有高 NDI，46 例有高 VAS 组，29 例有高 NDI 和 VAS 组。术后，较大的症状严重程度是 VAS 颈部（所有时间点；P ≤ 0.002，所有）、VAS 臂（6 周；P = 0.007）、NDI（6 周至 6 个月；P <0.001，所有）、SF 的显着预测因子-12 PCS（6 个月；P = 0.004）、P ROMIS PF（6 周；P = 0.007）和 PHQ-9（6 周至 6 个月；P <0.001，全部）。四个严重程度组之间 VAS 手臂、NDI 和 VAS 颈部的平均术后改善情况不同（1 年除外）（全部P ≤ 0.002）。VAS 组和 NDI 中症状严重程度较高的组的总体 MCID 达到率显着更高（P ≤ 0.003，均为 P ≤ 0.003）。

结论： 

NDI、VAS 颈部和 VAS 手臂的 PROM 改善和 MCID 成就因症状严重程度而异。