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P112. Cervical disc replacement for radiculopathy versus myeloradiculopathy: An MCID analysis

Several previous randomized controlled trials have documented the success of cervical disc replacement (CDR) in treating radiculopathy and/or myelopathy, but many did not systematically compare outcomes of patients with radiculopathy versus those with myelopathy. Currently, there is still controvers...

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Bibliographic Details
Published in:The spine journal 2021-09, Vol.21 (9), p.S195-S195
Main Authors: Alluri, Ram K., Vaishnav, Avani S., Sivaganesan, Ahilan, Melissaridou, Dimitra, Lee, Ryan, Urakawa, Hikari, Sato, Kosuke, Chaudhary, Chirag, Mok, Jung, Colaizzo, Derek, Chandra, Akhil, Dupont, Marcel, Sheha, Evan, Huang, Russel C., Albert, Todd J., Gang, Catherine Himo, Qureshi, Sheeraz A.
Format: Article
Language:English
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Summary:Several previous randomized controlled trials have documented the success of cervical disc replacement (CDR) in treating radiculopathy and/or myelopathy, but many did not systematically compare outcomes of patients with radiculopathy versus those with myelopathy. Currently, there is still controversy about whether CDR utilization in patients with components of myelopathy can result in equivalent outcomes when compared to its use in patients with only radiculopathy. The purpose of the present study was to compare the minimally clinically important difference (MCID) across multiple patient-reported outcomes (PROs) in patients undergoing CDR for cervical spondylotic radiculopathy versus myeloradiculopathy. Retrospective review of prospectively collected data. Patients who underwent one or two-level CDR with radiculopathy versus myeloradiculopathy. Neck Disability Index (NDI), VAS-Neck, VAS-Arm, Short Form-12 Health Survey (SF-12) Physical Component Score (PCS), SF-12 Mental Component Score (MCS), PROMIS Physical Function (PF). Demographic variables and operative characteristics were analyzed for differences between patients with radiculopathy versus myeloradiculopathy. PROs were assessed for differences between the two diagnosis groups as well as improvements within each group following surgery. An MCID analysis of PROs for each diagnosis group was performed and the percentage of patients achieving the MCID was compared between the two diagnosis groups. A total of 85 patients were included in the present study, of which 48 (56%) had radiculopathy and 37 (44%) had myeloradiculopathy. Average follow-up was 13.4 months. There were no significant differences in preoperative demographic variables, or the number and distribution of cervical levels treated between the two diagnosis groups. There were no significant differences in preoperative NDI, Neck-VAS, Arm-VAS, SF-12 PCS, SF-12 MCS, and PROMIS PF scores between the two groups. At the final postoperative visit, there was no significant difference in each PRO assessed between the radiculopathy and myeloradiculopathy groups and both groups demonstrated statistically significant improvement in each PRO compared to preoperative values (P
ISSN:1529-9430
1878-1632
DOI:10.1016/j.spinee.2021.05.320