Criteria for success after surgery for cervical radiculopathy-estimates for a substantial amount of improvement in core outcome measures.

Cervical Vertebrae / surgery Humans Norway Outcome Assessment, Health Care Prospective Studies Radiculopathy / surgery Treatment Outcome
Cervical degenerative radiculopathy Cervical disc herniation Cohort study EuroQol NECK Disability Index Numerical rating scale Patient-reported outcome measures Spondylotic foraminal stenosis Success criteria

Journal

The spine journal : official journal of the North American Spine Society
ISSN: 1878-1632
Titre abrégé: Spine J
Pays: United States
ID NLM: 101130732

Informations de publication

Date de publication:
09 2020
Historique:
received: 24 01 2020
revised: 24 05 2020
accepted: 25 05 2020
pubmed: 6 6 2020
medline: 23 6 2021
entrez: 6 6 2020
Statut: ppublish

Résumé

Defining clinically meaningful success criteria from patient-reported outcome measures (PROMs) is crucial for clinical audits, research and decision-making. We aimed to define criteria for a successful outcome 3 and 12 months after surgery for cervical degenerative radiculopathy on recommended PROMs. Prospective cohort study with 12 months follow-up. Patients operated at one or two levels for cervical radiculopathy included in the Norwegian Registry for Spine Surgery (NORspine) from 2011 to 2016. Neck disability index (NDI), Numeric Rating Scale for neck pain (NRS-NP) and arm pain (NRS-AP), health-related quality-of-life EuroQol 3L (EQ-5D), general health status (EQ-VAS). We included 2,868 consecutive cervical degenerative radiculopathy patients operated for cervical radiculopathy in one or two levels and included in the Norwegian Registry for Spine Surgery (NORspine). External criterion to determine accuracy and optimal cut-off values for success in the PROMs was the global perceived effect scale. Success was defined as "much better" or "completely recovered." Cut-off values were assessed by analyzing the area under the receiver operating curves for follow-up scores, mean change scores, and percentage change scores. All PROMs showed high accuracy in defining success and nonsuccess and only minor differences were found between 3- and 12-month scores. At 12 months, the area under the receiver operating curves for follow-up scores were 0.86 to 0.91, change scores were 0.74 to 0.87, and percentage change scores were 0.74 to 0.91. Percentage scores of NDI and NRS-AP showed the best accuracy. The optimal cut-off values for each PROM showed considerable overlap across those operated due to disc herniation and spondylotic foraminal stenosis. All PROMs, especially NDI and NRS-AP, showed good to excellent discriminative ability in distinguishing between a successful and nonsuccessful outcome after surgery due to cervical radiculopathy. Percentage change scores are recommended for use in research and clinical practice.

Sections du résumé

BACKGROUND CONTEXT
Defining clinically meaningful success criteria from patient-reported outcome measures (PROMs) is crucial for clinical audits, research and decision-making.
PURPOSE
We aimed to define criteria for a successful outcome 3 and 12 months after surgery for cervical degenerative radiculopathy on recommended PROMs.
STUDY DESIGN
Prospective cohort study with 12 months follow-up.
PATIENT SAMPLE
Patients operated at one or two levels for cervical radiculopathy included in the Norwegian Registry for Spine Surgery (NORspine) from 2011 to 2016.
OUTCOME MEASURES
Neck disability index (NDI), Numeric Rating Scale for neck pain (NRS-NP) and arm pain (NRS-AP), health-related quality-of-life EuroQol 3L (EQ-5D), general health status (EQ-VAS).
METHODS
We included 2,868 consecutive cervical degenerative radiculopathy patients operated for cervical radiculopathy in one or two levels and included in the Norwegian Registry for Spine Surgery (NORspine). External criterion to determine accuracy and optimal cut-off values for success in the PROMs was the global perceived effect scale. Success was defined as "much better" or "completely recovered." Cut-off values were assessed by analyzing the area under the receiver operating curves for follow-up scores, mean change scores, and percentage change scores.
RESULTS
All PROMs showed high accuracy in defining success and nonsuccess and only minor differences were found between 3- and 12-month scores. At 12 months, the area under the receiver operating curves for follow-up scores were 0.86 to 0.91, change scores were 0.74 to 0.87, and percentage change scores were 0.74 to 0.91. Percentage scores of NDI and NRS-AP showed the best accuracy. The optimal cut-off values for each PROM showed considerable overlap across those operated due to disc herniation and spondylotic foraminal stenosis.
CONCLUSIONS
All PROMs, especially NDI and NRS-AP, showed good to excellent discriminative ability in distinguishing between a successful and nonsuccessful outcome after surgery due to cervical radiculopathy. Percentage change scores are recommended for use in research and clinical practice.

Identifiants

DOI: 10.1016/j.spinee.2020.05.549 PMID: 32502657
pubmed: 32502657
pii: S1529-9430(20)30770-1
doi: 10.1016/j.spinee.2020.05.549
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1413-1421

Informations de copyright

Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.

Auteurs

Christer Mjåset (C)

Research and Communication Unit for Musculoskeletal Health (FORMI), Oslo University Hospital, Oslo, Norway; Department of Neurosurgery, Oslo University Hospital, Oslo, Norway. Electronic address: chrmja@gmail.com.

John-Anker Zwart (JA)

Faculty of Medicine, University of Oslo, Oslo, Norway; Research and Communication Unit for Musculoskeletal Health (FORMI), Oslo University Hospital, Oslo, Norway.

Caroline M W Goedmakers (CMW)

Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands; Computational Neuroscience Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women's Hospital, School of Medicine, Harvard University, Boston, MA, USA.

Timothy R Smith (TR)

Computational Neuroscience Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women's Hospital, School of Medicine, Harvard University, Boston, MA, USA.

Tore K Solberg (TK)

Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway; Institute of Clinical Medicine, The Arctic University of Norway (UiT), Tromsø, Norway.

Margreth Grotle (M)

Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway; Research and Communication Unit for Musculoskeletal Health (FORMI), Oslo University Hospital, Oslo, Norway.

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Classifications MeSH

questionsmedicales.fr › Appareil locomoteur › Squelette › Rachis › Vertèbres cervicales › Criteria for success after surgery for...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Criteria for success after surgery for...
questionsmedicales.fr › Régions géographiques › Europe › Pays nordiques et scandinaves › Norvège › Criteria for success after surgery for...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Criteria for success after surgery for...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Criteria for success after surgery for...
questionsmedicales.fr › Maladies du système nerveux › Maladies neuromusculaires › Neuropathies périphériques › Radiculopathie › Criteria for success after surgery for...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Criteria for success after surgery for...