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Coexisting Lower Back Pain in Patients With Cervical Myelopathy
Hiroyuki Nakarai1,2, So Kato2,3, Yujiro Hirao4
1Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY.
Clinical Spine Surgery
|January 21, 2024
Summary
Cervical myelopathy surgery significantly improved coexisting lower back pain (LBP) in over half of patients, with 47% achieving clinically meaningful improvement. Treating cervical myelopathy may alleviate associated LBP.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Disorders
Background:
- Lower back pain (LBP) is a common comorbidity in patients with cervical myelopathy.
- Limited research exists on the impact of cervical myelopathy surgery on coexisting LBP.
Purpose of the Study:
- To investigate the prevalence of LBP in cervical myelopathy patients.
- To evaluate the effect of cervical spine surgery on LBP.
Main Methods:
- Retrospective cohort study of 786 patients undergoing cervical decompression surgery.
- Utilized patient-reported outcomes including the Japanese Orthopaedic Association (PRO-JOA) score and Numerical Rating Scales (NRS) for LBP.
- Analyzed factors contributing to clinically meaningful improvement in LBP.
Main Results:
- 67% of patients had concurrent LBP, associated with higher BMI and worse preoperative PRO-JOA scores.
- Postoperative LBP significantly improved (mean NRS 4.5 to 3.4), with 47% achieving the minimum clinically important difference (MCID).
- A PRO-JOA recovery rate >50% was strongly associated with achieving MCID for LBP.
Conclusions:
- Cervical spine surgery can lead to significant LBP improvement in patients with cervical myelopathy.
- A better PRO-JOA recovery rate post-surgery correlates with LBP improvement.
- Addressing cervical myelopathy may be sufficient to manage coexisting LBP.
