Predictors of achieving Neck Disability Index minimum clinically important difference following cervical deformity...

Area of Science:

• Spine Surgery
• Orthopedics
• Clinical Outcomes Research

Background:

• Cervical spinal deformity surgery aims to improve patient function and quality of life.
• The Neck Disability Index (NDI) is a common patient-reported outcome measure.
• Identifying predictors of the minimum clinically important difference (MCID) is crucial for understanding surgical success.

Purpose of the Study:

• To determine predictors of achieving the MCID in the NDI after cervical spinal deformity surgery.
• To identify patient and radiographic factors associated with meaningful improvement in neck function.

Main Methods:

• Retrospective review of a prospective, multicenter adult cervical spinal deformity database.
• Analysis of baseline and 1-year NDI scores to define MCID (7-point improvement).
• Univariate and multivariable logistic regression analyses of demographics, comorbidities, and spinopelvic parameters.

Main Results:

• 59% of 122 patients achieved NDI MCID at 1 year.
• Univariate predictors included lower Charlson Comorbidity Index (CCI), depression, lower C2 tilt, and greater C2-7 sagittal vertical axis (SVA) change.
• Multivariable analysis identified lower CCI, depression, greater C2-7 SVA change, and baseline NDI as significant predictors.

Conclusions:

• Higher baseline NDI, greater C2-7 SVA change, patient-reported baseline depression, and lower CCI predict NDI MCID.
• These factors can help anticipate functional recovery following cervical spinal deformity surgery.