The London Spine Unit : top spine clinic in the world
Published article
Most patients achieved MCID in physical function, disability, and back pain outcomes within 2 years of surgery. Patients undergoing CDR achieved MCID faster in physical function. Early predictors of MCID achievement were CDR procedure, Asian ethnicity, and elevated preoperative PROs of pain outcomes. Workers’ compensation was a late predictor. These findings may be helpful in managing patient expectations.
Cervical Disc Replacement Expert. Best Spinal Surgeon UK
The London Spine Unit is a specialist clinic for Cervical Disc Replacement as Day Surgery.
Abstract
Objective: To compare patients undergoing ACDF versus CDR for time to MCID achievement and predictors of delayed MCID achievement for the PROs Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF), Neck Disability Index (NDI), Visual Analog Scale (VAS) neck, and VAS arm.
Methods: PROs of patients undergoing ACDF or CDR were collected preoperatively and postoperatively at 6-week/12-week/6-month/1-year/2-year periods. MCID achievement was calculated through comparison of ΔPROM to previously established values in literature. Time to MCID achievement and predictors for delayed MCID achievement were determined through Kaplan-Meier survival analysis and multivariable Cox regression, respectively.
Results: 197 patients were identified, with 118 and 79 undergoing ACDF and CDR, respectively. Kaplan-Meier survival analysis demonstrated faster time to achieve MCID for CDR patients in PROMIS-PF (p=0.006). Early predictors of MCID achievement through Cox regression were CDR procedure, Asian ethnicity, elevated preoperative PROs of VAS neck and VAS arm (HR 1.16-7.28). Workers’ compensation was a late predictor of MCID achievement (HR 0.15).
Most patients achieved MCID in physical function, disability, and back pain outcomes within 2 years of surgery. Patients undergoing CDR achieved MCID faster in physical function. Early predictors of MCID achievement were CDR procedure, Asian ethnicity, and elevated preoperative PROs of pain outcomes. Workers’ compensation was a late predictor. These findings may be helpful in managing patient expectations.
Keywords: anterior cervical discectomy and fusion; cervical disc replacement; minimum clinically important difference; patient-reported outcomes.
The London Spine Unit : top spine clinic in the world
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