How Do Patients With Predominant Neck Pain Improve After Anterior Cervical Discectomy and Fusion for Cervical Radiculopathy?

Authors

• Srikanth N Divi
• Dhruv K C Goyal
• Barrett I Woods
• Kristen J Nicholson
• Harold I Salmons
• Matthew S Galetta
• Mahir A Qureshi
• Meghan E Lam
• Andrew L DiMatteo
• D Greg Anderson
• Mark F Kurd
• Jeffrey A Rihn
• Ian D Kaye
• Christopher K Kepler
• Alan S Hilibrand
• Alexander R Vaccaro
• Kristen E Radcliff
• Gregory D Schroeder

Publication/Presentation Date

4-1-2022

Abstract

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 (

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.

Volume

16

Issue

2

First Page

240

Last Page

246

ISSN

2211-4599

Published In/Presented At

Divi, S. N., Goyal, D. K. C., Woods, B. I., Nicholson, K. J., Salmons, H. I., Galetta, M. S., Qureshi, M. A., Lam, M. E., DiMatteo, A. L., Greg Anderson, D., Kurd, M. F., Rihn, J. A., Kaye, I. D., Kepler, C. K., Hilibrand, A. S., Vaccaro, A. R., Radcliff, K. E., & Schroeder, G. D. (2022). How Do Patients With Predominant Neck Pain Improve After Anterior Cervical Discectomy and Fusion for Cervical Radiculopathy?. International journal of spine surgery, 16(2), 240–246. https://doi.org/10.14444/8212

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

35273114

Department(s)

Administration and Leadership

Document Type

Article