Does Hybrid Surgery Improve Quality of Life in Multilevel Cervical Degenerative Disk Disease? Five-Year Follow-up Study.
Adult
Aged
Cervical Vertebrae
/ surgery
Combined Modality Therapy
Decompression, Surgical
/ methods
Deglutition Disorders
/ epidemiology
Female
Follow-Up Studies
Humans
Intervertebral Disc Degeneration
/ complications
Magnetic Resonance Imaging
Male
Middle Aged
Patient Satisfaction
Postoperative Complications
/ epidemiology
Quality of Life
Radiculopathy
/ etiology
Spinal Cord Compression
/ etiology
Spinal Fusion
/ methods
Total Disc Replacement
/ methods
Treatment Outcome
Anterior cervical diskectomy fusion
Artificial disk replacement
Functional scores
Hybrid surgery
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
23
02
2020
revised:
16
03
2020
accepted:
17
03
2020
entrez:
17
8
2020
pubmed:
17
8
2020
medline:
17
12
2020
Statut:
ppublish
Résumé
Patient satisfaction is becoming an increasing factor worthy of consideration when evaluating the surgical quality. The correlation between patient satisfaction and surgical outcomes 5 years after cervical hybrid surgery (HS), which incorporates anterior cervical decompression and fusion and cervical disk arthroplasty techniques in multilevel cervical degenerative disk disease, has not been evaluated. The aim of this study was firstly to analyze prospectively collected data from a sample of patients (n = 50) treated with cervical HS for selected cases of radiculopathy and myelopathy in order to evaluate pain levels of patients, using the Neck and Arm Pain scale as an expression of visual analog scale. Secondly, we aimed to evaluate health-related quality of life, via the short-form 36, Neck Disability Index, and Japanese Orthopedic Association score. Patients were followed up for more than 5 years. Intraoperative parameters, clinical features, and outcome scores were recorded. Radiologic investigations including disk height and changes in adjacent disk spaces were assessed. Clinical improvements were observed in all outcomes; significant improvements on the Neck Disability Index, visual analog scale, short-form 36, and Japanese Orthopedic Association scores were maintained at 5 years (P < 0.05). The mean disk height resulted restored in all the cases. Temporary dysphagia was rarely observed (3%). No surgery for adjacent-level disease was required. There was no significant difference in the outcomes between radiculopathy and myelopathy groups (P > 0.05). HS is an effective and safe procedure for the treatment of multilevel cervical degenerative disk disease. Such a surgical construct offers postoperative improvement on pain levels and health-related quality of life.
Sections du résumé
BACKGROUND
Patient satisfaction is becoming an increasing factor worthy of consideration when evaluating the surgical quality. The correlation between patient satisfaction and surgical outcomes 5 years after cervical hybrid surgery (HS), which incorporates anterior cervical decompression and fusion and cervical disk arthroplasty techniques in multilevel cervical degenerative disk disease, has not been evaluated.
METHODS
The aim of this study was firstly to analyze prospectively collected data from a sample of patients (n = 50) treated with cervical HS for selected cases of radiculopathy and myelopathy in order to evaluate pain levels of patients, using the Neck and Arm Pain scale as an expression of visual analog scale. Secondly, we aimed to evaluate health-related quality of life, via the short-form 36, Neck Disability Index, and Japanese Orthopedic Association score. Patients were followed up for more than 5 years. Intraoperative parameters, clinical features, and outcome scores were recorded. Radiologic investigations including disk height and changes in adjacent disk spaces were assessed.
RESULTS
Clinical improvements were observed in all outcomes; significant improvements on the Neck Disability Index, visual analog scale, short-form 36, and Japanese Orthopedic Association scores were maintained at 5 years (P < 0.05). The mean disk height resulted restored in all the cases. Temporary dysphagia was rarely observed (3%). No surgery for adjacent-level disease was required. There was no significant difference in the outcomes between radiculopathy and myelopathy groups (P > 0.05).
CONCLUSIONS
HS is an effective and safe procedure for the treatment of multilevel cervical degenerative disk disease. Such a surgical construct offers postoperative improvement on pain levels and health-related quality of life.
Identifiants
pubmed: 32797985
pii: S1878-8750(20)30568-4
doi: 10.1016/j.wneu.2020.03.097
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
527-533Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.