Correlation of neural foraminal motion after surgical treatment of cervical radiculopathy with long-term patient reported outcomes.
Cervical spondylosis
patient reported outcomes (PRO)
range of motion
spinal fusion
total disc replacement
Journal
Journal of spine surgery (Hong Kong)
ISSN: 2414-469X
Titre abrégé: J Spine Surg
Pays: China
ID NLM: 101685460
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
entrez:
21
4
2020
pubmed:
21
4
2020
medline:
21
4
2020
Statut:
ppublish
Résumé
Post-surgical changes in adjacent segment motion are considered a factor in further development of degeneration and cervical radiculopathy. The objective was to examine the extent of correlations between physiological motion of cervical foramina and long-term patient reported outcomes (PRO). Biplane X-ray imaging and CT-based markerless tracking were used to measure 3D static and dynamic dimensions during neck axial rotation and extension from 18 patients treated for C5-6 radiculopathy with fusion or arthroplasty. Minimum foraminal height (FH.Min) and width (FW.Min), and their range (FH.Range and FW.Range) achieved during a motion task were calculated for adjacent levels (C4-5 and C6-7) at 2.0±0.6 years post-surgery. The modified Japanese Orthopedic Association score (mJOAS), the Neck Disability Index (NDI) including the visual analogue scale (VAS) for neck and arm pain, and the EuroQol EQ-5D score were recorded at 6.5±1.1 years post-surgery. The relationships between 6.5-year outcomes and 2-year foraminal motion were examined using regression. Worsening patient-reported outcomes were generally associated with lower values of FW.Min (P<0.05 to P<0.008), the associations being stronger for neck extension (r Dynamic 3D foraminal dimensions at 2-year post-surgery, notably FW.Min measured in neck extension at adjacent levels, were associated with PRO at 6.5 years post-surgery. These relationships provide insight into the motion related factors in development of pain and loss of function, and may help develop markers or objective outcome measures.
Sections du résumé
BACKGROUND
BACKGROUND
Post-surgical changes in adjacent segment motion are considered a factor in further development of degeneration and cervical radiculopathy. The objective was to examine the extent of correlations between physiological motion of cervical foramina and long-term patient reported outcomes (PRO).
METHODS
METHODS
Biplane X-ray imaging and CT-based markerless tracking were used to measure 3D static and dynamic dimensions during neck axial rotation and extension from 18 patients treated for C5-6 radiculopathy with fusion or arthroplasty. Minimum foraminal height (FH.Min) and width (FW.Min), and their range (FH.Range and FW.Range) achieved during a motion task were calculated for adjacent levels (C4-5 and C6-7) at 2.0±0.6 years post-surgery. The modified Japanese Orthopedic Association score (mJOAS), the Neck Disability Index (NDI) including the visual analogue scale (VAS) for neck and arm pain, and the EuroQol EQ-5D score were recorded at 6.5±1.1 years post-surgery. The relationships between 6.5-year outcomes and 2-year foraminal motion were examined using regression.
RESULTS
RESULTS
Worsening patient-reported outcomes were generally associated with lower values of FW.Min (P<0.05 to P<0.008), the associations being stronger for neck extension (r
CONCLUSIONS
CONCLUSIONS
Dynamic 3D foraminal dimensions at 2-year post-surgery, notably FW.Min measured in neck extension at adjacent levels, were associated with PRO at 6.5 years post-surgery. These relationships provide insight into the motion related factors in development of pain and loss of function, and may help develop markers or objective outcome measures.
Identifiants
pubmed: 32309642
doi: 10.21037/jss.2020.03.02
pii: jss-06-01-18
pmc: PMC7154365
doi:
Types de publication
Journal Article
Langues
eng
Pagination
18-25Informations de copyright
2020 Journal of Spine Surgery. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest: SW Bartol owns shares in Sentio LLC, is a consultant for LDR and DePuy Synthes, and a member of the Medical Board of Trustees of MTF. A Basheer is a consultant for DePuy/Synthes Spine and SeaSpine. V Chang is a consultant for Globus Medical and SpineGuard. The other authors have no conflicts of interest to declare.
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