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Cervical Disc Replacement for Radiculopathy Versus Myeloradiculopathy: An MCID Analysis
Ram K Alluri1, Avani S Vaishnav1, Ahilan Sivaganesan1
1Hospital for Special Surgery.
Clinical Spine Surgery
|May 4, 2022
Summary
Patients undergoing cervical disc replacement (CDR) for radiculopathy or myeloradiculopathy showed similar rates of achieving minimally clinically important differences (MCID) in patient-reported outcomes. Improvements in outcomes continued post-surgery for both conditions.
Area of Science:
- Neurosurgery
- Orthopedics
- Patient-Reported Outcomes
Background:
- Cervical disc replacement (CDR) is used for cervical spondylotic radiculopathy and myeloradiculopathy.
- Previous studies show similar outcomes but focus on statistical significance, not patient-perceived improvement.
Purpose of the Study:
- Compare minimally clinically important difference (MCID) in patient-reported outcomes (PROs) after CDR.
- Differentiate outcomes between cervical spondylotic radiculopathy and myeloradiculopathy.
Main Methods:
- Retrospective review of 85 patients undergoing 1- or 2-level CDR.
- Collected PROs included Neck Disability Index (NDI), VAS-Neck/Arm, SF-12 (PCS/MCS), and PROMIS Physical Function.
- Compared the percentage of patients achieving MCID between radiculopathy and myeloradiculopathy groups.
Main Results:
- No significant difference in MCID achievement between radiculopathy and myeloradiculopathy groups at 6 weeks, 12 weeks, or final follow-up.
- MCID achievement generally increased from 6 weeks to final follow-up in both groups.
- Exception: SF-12 Mental Component Score (MCS) did not improve in the myeloradiculopathy group.
Conclusions:
- CDR yields comparable MCID rates for radiculopathy and myeloradiculopathy.
- Sustained improvement in PROs is observed post-CDR in both conditions.
- Focus on MCID provides insight into patient-centered success after CDR.
