Does neck pain as chief complaint influence the outcome of cervical total disc replacement?
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SUPPLEMENT ARTICLE
Does neck pain as chief complaint influence the outcome of cervical total disc replacement? S. Finkenstaedt1 · A. F. Mannion1 · T. F. Fekete1 · D. Haschtmann1 · F. S. Kleinstueck1 · U. Mutter1 · H. J. Becker1 · D. Bellut1 · F. Porchet1 Received: 31 March 2019 / Revised: 31 May 2019 / Accepted: 25 June 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract Purpose We investigated whether outcomes after cervical total disc replacement (cTDR) are influenced by preoperative neck pain as the chief complaint. Methods This was a retrospective study using data in our local spine surgery outcomes database, linked to EUROSPINE Spine Tango Registry. Patients completed questionnaires at baseline enquiring about the “chief complaint” [neck pain (NP), arm/shoulder pain (AP) or neurological deficits (ND)] and including the Core Outcome Measures Index (COMI); these were completed again at 24 months postoperatively, along with a rating of “global treatment outcome” (on a five-point scale, later dichotomized as “good” or “poor”). Differences in outcomes between the groups were examined using ANOVA. Multivariable regression analysis examined the effect of the chief pain location on 24-month outcomes, controlling for age, gender, comorbidity, baseline pain and COMI scores. Results One hundred and fifty-nine consecutive patients were included, with a chief complaint of NP in 31%, AP in 38% and ND in 31%. The chief complaint groups did not differ in relation to their baseline COMI scores or their reductions in score from before surgery to 24 months after surgery (reduction: NP group, 4.4 ± 2.9 points; AP group, 4.7 ± 2.7; ND group, 4.3 ± 2.9; p = 0.78). Similarly, the percentage of patients reporting a “good global treatment outcome” at 24 months postoperatively did not differ between the groups (NP, 79%; AP, 77%; ND, 85%; p = 0.64). The findings were consistent when controlling for possible confounders in multiple regression. Conclusions Having neck pain as opposed to arm pain or neurological deficits as preoperative chief complaint had no significant impact on clinical outcome after cTDR. Graphic abstract These slides can be retrieved under Electronic Supplementary Material.
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Take Home Messages 1. Preoperative neck pain as the chief complaint did not negatively influence the patient-rated outcome of cervical total disc replacement.
1. Neck pain 2. Cervical total disc replacement 3. Cervical Arthroplasty
Figure 1. Reduction in a) COMI score, b) the higher of the two pain scores (neck or arm), c) neck pain score and d) arm pain score, from preoperatively to 24 months’ follow-up, in groups of patients whose chief preoperative complaint was neck pain (NP), arm/shoulder pain (AP), or neurological deficit (ND).
Finkenstaedt S, Mannion AF, Fekete TF, Haschtmann D, Kleinstueck FS, Mutter U, Becker HJ, Bellut D, Porchet F (2019) Does neck pain as chief complaint influence the outcome of cervical total disc replacement? Eur Spine J;
Finkenstaedt S, Mannion AF, Fekete TF,
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