Comparing Health-Related Quality of Life Outcomes in Patients Undergoing Either Primary or Revision Anterior Cervical Discectomy and Fusion. Issue 13 (1st July 2018)

• Record Type: Journal Article
• Authors: Schroeder, Gregory D.; Boody, Barrett S.; Kepler, Christopher K.; Kurd, Mark F.; Silva, Stephen; Nicholson, Kristen; Wilson, Jefferson R.; Woods, Barret I.; Radcliff, Kris E.; Anderson, David Greg; Hilibrand, Alan S.; Vaccaro, Alexander R.; Rihn, Jeffery A.
• Is Part Of: Spine. Volume 43:Issue 13(2018)
• Publication Date: 2018-07-01
• Subjects: anterior cervical discectomy and fusion -- cervical myelopathy -- cervical radiculopathy -- outcomes -- primary -- quality of life -- revision -- symptomatic adjacent segment disease; Spine -- Abnormalities -- Periodicals; Spine -- Diseases -- Periodicals; Spine -- Surgery -- Periodicals; 616.73005
• DOI: 10.1097/BRS.0000000000002511
• Languages: English
• ISSNs: 0362-2436

Abstract

Abstract : Study Design: A retrospective review of prospectively collected data. Objective: Compare health-related quality of life (HRQOL) outcome metrics in patients undergoing primary and revision anterior cervical discectomy and fusion (ACDF). Summary of Background Data: ACDF is associated with significant improvements in HRQOL outcome metrics. However, 2.9% of patients per year will develop symptomatic adjacent segment disease and there is a paucity of literature on HRQOL outcomes after revision ACDF. Methods: Patients were identified who underwent either a primary or revision ACDF, and who had both preoperative and a minimum of 1-year postoperative HRQOL outcome data. Pre- and postoperative Short Form 12 Physical Component Score (SF12 PCS), Short Form 12 Mental Component Score (SF12 MCS) Visual Analog Scale for neck pain (VAS-Neck), VAS-Arm, and Neck Disability Index (NDI) scores were compared. Results: A total of 360 patients (299 primary, 61 revision) were identified. Significant improvement in SF12 PCS, NDI, VAS-Neck, and VAS-Arm was seen in both groups; however, only a significant improvement in SF12 MCS was seen in the primary group. When comparing the results of a primary versus a revision surgery, the SF12 PCS score was the only outcome with a significantly different net improvement in the primary group (7.23 ± 9.72) compared to the revision group (2.9 ± 11.07; P = 0.006) despite similar baseline SF12 PCS scores. The improvement in each of the other reported HRQOL outcomes did not significantly vary between surgical groups. Conclusion: A revision ACDF for cervical radiculopathy or myelopathy leads to a significant improvement in the HRQOL outcome, and with the exception of the SF12 PCS, these results are similar to those of patients undergoing a primary ACDF. Level of Evidence: 2