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Baseline Neck Disability Index and Patient-Reported Outcomes Measurement Information System Physical Function Predict
Gregory S Kazarian1, Michael E Steinhaus1, Sravisht Iyer1
1Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA.
International Journal of Spine Surgery
|October 9, 2024
Summary
Preoperative patient-reported outcome measures predict cervical spine surgery success. Worse baseline function, particularly radiculopathy, indicates a lower chance of achieving normal pain and function post-surgery.
Area of Science:
- Spine Surgery Outcomes
- Patient-Reported Outcome Measures (PROMs)
- Cervical Spine Disorders
Background:
- Identifying predictors of successful cervical spine surgery is crucial for patient selection.
- Previous studies highlight various preoperative factors influencing outcomes.
- Optimal patient selection for operative management remains unclear.
Purpose of the Study:
- To determine if preoperative PROMs can predict postoperative pain and function levels.
- To assess the utility of PROMs in identifying patients likely to achieve normal outcomes.
Main Methods:
- Prospective cohort study of 139 adult patients undergoing cervical spine surgery.
- Collected preoperative and 6-month postoperative Neck Disability Index (NDI) and PROMIS Physical Function (PF) and Pain Interference.
- Assessed the relationship between preoperative PROMs and achieving patient-acceptable symptom state (PASS) and normative function.
Main Results:
- Worse preoperative NDI scores significantly decreased the odds of achieving PASS (OR 0.96, P < 0.001), especially in radiculopathy patients.
- Improved preoperative PROMIS PF scores increased the odds of achieving normative function (OR 1.10, P < 0.001), particularly for radiculopathy.
- Predictive associations were less significant for patients with myelopathy.
Conclusions:
- Preoperative PROMs are valuable predictors of postoperative benefit in cervical spine surgery.
- Worse baseline function correlates with a lower likelihood of achieving satisfactory outcomes, especially for radiculopathy.
- Preoperative symptoms and function, including myelopathy/radiculopathy status, may guide surgical decision-making.
