Influence of Preoperative Physical Function Scores on Outcomes After Single-level Cervical Disc Replacement.

Area of Science:

• Orthopedic Surgery
• Spine Surgery
• Patient-Reported Outcomes

Background:

• Preoperative Patient-Reported Outcome Measurement Information System Physical Function (PROMIS-PF) scores are increasingly recognized as prognostic factors for surgical outcomes.
• While studies have explored this relationship in various orthopedic procedures, its specific impact on cervical disc replacement (CDR) remains less understood.

Purpose of the Study:

• To investigate the influence of preoperative PROMIS-PF scores on perioperative and postoperative outcomes following single-level CDR.
• To assess the achievement rates of minimum clinically important difference (MCID) based on preoperative PROMIS-PF levels.

Main Methods:

• A retrospective study identified patients who underwent single-level CDR and had preoperative PROMIS-PF scores.
• Patients were stratified into lower-functioning (PROMIS-PF <40) and higher-functioning (PROMIS-PF ≥40) groups.
• Outcomes including PROMIS-PF, SF-12 PCS, VAS (neck and arm), and Neck Disability Index were collected preoperatively and at multiple follow-up points.

Main Results:

• The higher-functioning group experienced increased operative times.
• Both groups showed improvements in most patient-reported outcome measures (PROMs), with the higher-functioning group reporting better postoperative PROMIS-PF scores initially.
• The lower-functioning group demonstrated significantly higher rates of MCID achievement for SF-12 PCS and VAS arm pain.

Conclusions:

• Preoperative PROMIS-PF scores influence postoperative outcomes in CDR patients.
• While higher-functioning patients reported better overall scores, lower-functioning patients achieved MCID more frequently, suggesting greater relative functional improvement.
• Patients with lower preoperative physical function may experience more substantial and clinically meaningful gains in function and arm pain after CDR.