Study Design: 

Retrospective analysis of outcomes in cervical spine and shoulder arthroscopy patients.

Objective: 

The objective of this study is to assess differential improvements in health-related quality of life for cervical spine surgery compared with shoulder surgery.

Summary of Background Data: 

An understanding of outcome differences between different types of orthopedic surgeries is helpful in counseling patients about expected postoperative recovery. This study compares outcomes in patients undergoing cervical spine surgery with arthroscopic shoulder surgery using computer-adaptive Patient-reported Outcome Information System scores.

Materials and Methods: 

Patients undergoing cervical spine surgery (1-level or 2-level anterior cervical discectomy and fusion, cervical disc replacement) or arthroscopic shoulder surgery (rotator cuff repair±biceps tenodesis) were grouped. Patient-reported Outcome Information System scores of physical function, pain interference, and pain intensity at baseline and at 3, 6, and 12 months were compared using paired t tests.

Results: 

Cervical spine (n=127) and shoulder (n=91) groups were similar in sex (25.8% vs. 41.8% female, P=0.731) but differed in age (51.6±11.6 vs. 58.60±11.2, P<0.05), operative time (148.3±68.6 vs. 75.9±26.9 min, P<0.05), American Society of Anesthesiologists (ASAs) (2.3±0.6 vs. 2.0±0.5, P=0.001), smoking status (15.7% vs. 4.4%, P=0.008), and length of stay (1.1±1.0 vs. 0.3±0.1, P=0.000). Spine patients had worse physical function (36.9 ±12.6 vs. 49.4±8.6, P<0.05) and greater pain interference (67.0±13.6 vs. 61.7±4.8, P=0.001) at baseline. Significant improvements were seen in all domains by 3 months for both groups, except for physical function after shoulder surgery. Spine patients had greater physical function improvements at all timepoints (3.33 vs. −0.43, P=0.003; 4.81 vs. 0.08, P=0.001; 6.5 vs. −5.24, P=<0.05). Conversely, shoulder surgery patients showed better 6-month improvement in pain intensity over spine patients (−8.86 vs. −4.46, P=0.001), but this difference resolved by 12 months.

Conclusions: 

Cervical spine patients had greater relative early improvement in physical function compared with shoulder patients, whereas pain interference and intensity did not significantly differ between the 2 groups after surgery. This will help in counseling patients about relative difference in recovery and improvement between the 2 surgery types.

Level of Evidence: 

III

中文翻译：

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对接受颈肩手术患者的健康相关生活质量改善的评估

学习规划： 

颈椎和肩关节镜手术患者结局的回顾性分析。

客观的： 

本研究的目的是评估与肩部手术相比，颈椎手术在健康相关生活质量方面的差异改善。

背景数据摘要： 

了解不同类型骨科手术之间的结果差异有助于为患者提供有关预期术后恢复的咨询。本研究使用计算机自适应患者报告结果信息系统评分比较了接受颈椎手术和肩关节镜手术的患者的结果。

材料和方法： 

将接受颈椎手术（1级或2级颈椎前路椎间盘切除融合术、颈椎间盘置换术）或肩关节镜手术（肩袖修复±二头肌肌腱固定术）的患者分组。使用配对t检验比较基线和 3、6 和 12 个月时患者报告的结果信息系统评分的身体功能、疼痛干扰和疼痛强度。

结果： 

颈椎组 (n=127) 和肩椎组 (n=91) 性别相似（25.8% vs. 41.8% 女性，P =0.731）但年龄不同（51.6±11.6 vs. 58.60±11.2，P <0.05） , 手术时间 (148.3±68.6 vs. 75.9±26.9 min, P <0.05), 美国麻醉医师协会 (ASAs) (2.3±0.6 vs. 2.0±0.5, P =0.001), 吸烟状况 (15.7% vs. 4.4%) , P =0.008), 和住院时间 (1.1±1.0 vs. 0.3±0.1, P =0.000)。脊柱患者身体机能更差（36.9±12.6 vs. 49.4±8.6，P <0.05），疼痛干扰更大（67.0±13.6 vs. 61.7±4.8，P=0.001) 在基线。到 3 个月时，两组的所有领域都有显着改善，除了肩部手术后的身体功能。脊柱患者在所有时间点都有更大的身体机能改善（3.33 对 -0.43，P =0.003；4.81 对 0.08，P =0.001；6.5 对 -5.24，P =<0.05）。相反，肩部手术患者在 6 个月后的疼痛强度改善优于脊柱患者（-8.86 对 -4.46，P = 0.001），但这种差异在 12 个月后消失。

结论： 

与肩部患者相比，颈椎患者在身体功能方面有更大的相对早期改善，而疼痛干扰和强度在术后两组之间没有显着差异。这将有助于就两种手术类型在恢复和改善方面的相对差异向患者提供咨询。

证据等级： 

三