The Effect of Preoperative Symptom Duration on Patient-Reported Outcomes After Anterior Cervical Discectomy and Fusion in Nonmyelopathic Patients: Analyses From the Michigan Spine Surgery Improvement Collaborative (MSSIC)
Document Type
Article
Publication Date
5-1-2023
Publication Title
Neurosurgery
Abstract
BACKGROUND: The effect of preoperative symptom duration (PSD) on patient-reported outcomes (PROs) in anterior cervical discectomy and fusion (ACDF) for radiculopathy is unclear.
OBJECTIVE: To determine whether PSD is a predictor for PRO after ACDF for radiculopathy.
METHODS: The Michigan Spine Surgery Improvement Collaborative registry was queried between March, 2014, and July, 2019, for patients who underwent ACDF without myelopathy and PROs (baseline, 90 days, 1 year, 2 years). PROs were measured by numerical rating scales for neck/arm pain, Patient-Reported Outcomes Measurement Information System Short Form-Physical Function (PROMIS-PF), EuroQol-5D (EQ5D), and North American Spine Society satisfaction. Univariate analyses were used to evaluate the proportion of patients reaching minimal clinically important differences (MCID). PSD wasmonths, 3 month-1 year, or >1 years. Multiple logistic regression models were used to estimate the association between PSD and PRO reaching MCID. The discriminative ability of the model was evaluated by receiver operating characteristic curve.
RESULTS: We included 2233 patients who underwent ACDF with PSD(278, 12.4%), 3 month-1 year (669, 30%), and >1 years (1286, 57.6%). Univariate analyses demonstrated a greater proportion of patients achieving MCID in1 years was associated with decreased odds of achieving MCID for EQ5D (odds ratio 0.5, CI 0.32-0.80, P = .004). Private insurance and increased baseline PRO were associated with significantly higher odds for achieving PROMIS-PF MCID and EQ5D-MCID.
CONCLUSION: Preoperative symptom duration greater than 1 year in patients who underwent ACDF for radiculopathy was associated with worse odds of achieving MCID for multiple PROs.
Volume
92
Issue
5
First Page
955
Last Page
962
Recommended Citation
Lawless MH, Tong D, Claus CF, Hanson C, Li C, Park P, et al. [Houseman CM, Bono PL, Carr DA, Richards BF, Kelkar PS,Soo TM]. The effect of preoperative symptom duration on patient-reported outcomes after anterior cervical discectomy and fusion in nonmyelopathic patients: analyses from the Michigan Spine Surgery Improvement Collaborative (MSSIC). Neurosurgery. 2023 May 1;92(5):955-962. doi: 10.1227/neu.0000000000002295. PMID: 36524819.
DOI
10.1227/neu.0000000000002295
ISSN
1524-4040
PubMed ID
36524819