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Wibault J1, Löfgren H2, Dedering Å3, Öberg B4, Zsigmond P5, Peolsson A4
1Linköping University, Department of Advices, Activity and Health, and Department of Medicine and Health, Linköping, Sweden, 2Ryhov Hospital, Neuro-Orthopedic Center, Jönköping, Sweden, 3Karolinska University Hospital, Allied Health Professionals Function, Function Area Occupational Therapy and Physiotherapy, Stockholm, Sweden, 4Linköping University, Department of Medicine and Health, Physiotherapy, Linköping, Sweden, 5Linköping University Hospital, Neurosurgery, Linköping, Sweden
Background: Persistent neck-related activity limitations, and/or participation restrictions are common at long-term follow-up in patients who undergo surgery for cervical radiculopathy (CR) due to disc disease. Neck loading exercises are tolerated after surgery, and some patients may benefit from additional postoperative rehabilitation for improved neck function. Early postoperative predictors of one year outcome for neck function after surgery for CR have not been studied. Patient counselling regarding the long-term outcome for neck function after surgery, and potential benefit of postoperative rehabilitation is limited.
Purpose: To study early postoperative predictors of one year neck function outcome after surgery for CR due to disc disease
Methods: This was a secondary analysis of a randomized clinical trial that included 201 patients who underwent surgery for CR. Neck function was measured with the Neck Disability Index (NDI) before surgery, and at 3 months (82% answer rate), and 1 year (67% answer rate) follow-up after surgery. Univariate and multiple logistic regressions were applied to study early predictors at 3 months follow-up for reporting no substantial improvement on the NDI one year after surgery. No substantial improvement on the NDI after surgery for CR was defined as less than a 10 points score change on the NDI.
Results: No substantial improvement on the NDI one year after surgery was reported by 65 patients (48%). Early postoperative predictors of one year outcome on the NDI were no substantial improvement on the NDI (odds ratio OR 13.71), no substantial improvement for neck pain intensity (OR 4.17), arm pain intensity (OR 2.11), and low satisfaction with symptoms (OR 4.84) 3 months after surgery. Reporting no substantial improvement on the NDI (OR 10.00) and low satisfaction with symptoms (OR 2.53) 3 months after surgery were the strongest predictors of a poor one year outcome on the NDI in a multiple model that explained between 30.4% and 40.5% of the variance in the outcome.
Conclusion(s): Nearly half of the patients reported no substantial improvement in neck function one year after surgery for CR. Early postoperative predictors of one year neck function outcome after surgery for CR were no substantial improvement in neck function, and low satisfaction with symptoms 3 months after surgery.
Implications: Patients who report no substantial improvement in neck function outcome and low satisfaction with symptoms 3 months after surgery for CR are more likely to report restrictions in neck function outcome one year after surgery. The use of NDI score change from before surgery to 3 months follow-up after surgery for CR may contribute to improve patient counselling regarding the long-term outcomes for neck function after surgery for CR. Future studies should investigate if structured postoperative rehabilitation can improve long-term neck function outcome in patients who report no substantial improvement in neck function 3 months after surgery for CR.
Keywords: Cervical radiculopathy, Outcome, Neck Disability Index
Funding acknowledgements: The authors acknowledge financial support from the Swedish Research Council for Medicine and Health
Purpose: To study early postoperative predictors of one year neck function outcome after surgery for CR due to disc disease
Methods: This was a secondary analysis of a randomized clinical trial that included 201 patients who underwent surgery for CR. Neck function was measured with the Neck Disability Index (NDI) before surgery, and at 3 months (82% answer rate), and 1 year (67% answer rate) follow-up after surgery. Univariate and multiple logistic regressions were applied to study early predictors at 3 months follow-up for reporting no substantial improvement on the NDI one year after surgery. No substantial improvement on the NDI after surgery for CR was defined as less than a 10 points score change on the NDI.
Results: No substantial improvement on the NDI one year after surgery was reported by 65 patients (48%). Early postoperative predictors of one year outcome on the NDI were no substantial improvement on the NDI (odds ratio OR 13.71), no substantial improvement for neck pain intensity (OR 4.17), arm pain intensity (OR 2.11), and low satisfaction with symptoms (OR 4.84) 3 months after surgery. Reporting no substantial improvement on the NDI (OR 10.00) and low satisfaction with symptoms (OR 2.53) 3 months after surgery were the strongest predictors of a poor one year outcome on the NDI in a multiple model that explained between 30.4% and 40.5% of the variance in the outcome.
Conclusion(s): Nearly half of the patients reported no substantial improvement in neck function one year after surgery for CR. Early postoperative predictors of one year neck function outcome after surgery for CR were no substantial improvement in neck function, and low satisfaction with symptoms 3 months after surgery.
Implications: Patients who report no substantial improvement in neck function outcome and low satisfaction with symptoms 3 months after surgery for CR are more likely to report restrictions in neck function outcome one year after surgery. The use of NDI score change from before surgery to 3 months follow-up after surgery for CR may contribute to improve patient counselling regarding the long-term outcomes for neck function after surgery for CR. Future studies should investigate if structured postoperative rehabilitation can improve long-term neck function outcome in patients who report no substantial improvement in neck function 3 months after surgery for CR.
Keywords: Cervical radiculopathy, Outcome, Neck Disability Index
Funding acknowledgements: The authors acknowledge financial support from the Swedish Research Council for Medicine and Health
Topic: Musculoskeletal: spine; Disability & rehabilitation
Ethics approval required: Yes
Institution: Department of Medicine and Health, Linköping university
Ethics committee: Regional ethical review board in Linköping
Ethics number: Dnr-M126-08
All authors, affiliations and abstracts have been published as submitted.
