Factors Affecting the Outcome of Surgical Versus Nonsurgical Treatment of Cervical Radiculopathy

Engquist, Markus; Löfgren, Håkan; Öberg, Birgitta; Holtz, Anders; Peolsson, Anneli; Söderlund, Anne; Vavruch, Ludek; Lind, Bengt

doi:10.1097/brs.0000000000001064

Cited by 28 publications

(41 citation statements)

References 18 publications

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“…The methodological characteristics of the articles found are similar, with 16 observational studies (9)(10)(13)(14)(18)(19)(20)(21)(22)24,26,(30)(31)(32)(33)(34) ; six prospective cohorts (25,(27)(28)34,(36)(37) ; one retrospective cohort (38) , one quasi-experimental study (35) , and one experimental study (29) . The use of instruments occurred in the immediate preoperative period in 21 studies that assessed patients' expectations (10,14,(18)(19)(20)(21)(22)(23)(24)(25)(26)(28)(29)(30)(31)(32)(33) , whereas in two studies it occurred when the patient received the indication of surgical treatment (9,27) , one study used them in the intermediate preoperative period (13) ; finally, one study completed the instrument after the patient underwent a spine surgery (34) . Three catego...…”

Section: Resultsmentioning

confidence: 76%

“…The studies were published between 1998 and 2015 and, in general, publications on this subject increased in the last five years (9)(10)14,(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) . The methodological characteristics of the articles found are similar, with 16 observational studies (9)(10)(13)(14)(18)(19)(20)(21)(22)24,26,(30)(31)(32)(33)(34) ; six prospective cohorts (25,(27)(28)34,(36)(37) ; one retrospective cohort (38) , one quasi-experimental study (35) , and one experimental study (29) . The use of instruments occurred in the immediate preoperative period in 21 studies that assessed patients' expectations (10,14,(18)(19)(20)(21)(22)…”

Section: Resultsmentioning

confidence: 99%

“…In four of the 17 articles in this category, the researchers used the VAS as a way to measure expectation (21)(22)(23)36) , seven studies used a Likert scale (24,(26)(27)32,(34)(35)37) , and finally, in six studies the researchers created closed-ended questions addressing patients' expectations toward surgery (18,25,29,31,33,38) . Of these studies, in most cases, patients' expectation facing their main symptoms, such as pain, muscle function, and sensitivity (18, Instruments used in the assessment of expectation toward a spine surgery: an integrative review the general state of health, overall success of the surgery and recovery (23,29,31,33,35,36) ; two studies evaluated return to work (24,31) , and one assessed the social role (18) .…”

Section: Vilà-canet Et Almentioning

confidence: 99%

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Instruments used in the assessment of expectation toward a spine surgery: an integrative review

Nepomuceno

Silveira

Dessotte

et al. 2016

Rev. esc. enferm. USP

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Objective:To identify and describe the instruments used to assess patients' expectations toward spine surgery. Method: An integrative review was carried out in the databases PubMed, CINAHL, LILACS and PsycINFO. Results: A total of 4,402 publications were identified, of which 25 met the selection criteria. Of the studies selected, only three used tools that had confirmed validity and reliability to be applied; in five studies, clinical scores were used, and were modified for the assessment of patients' expectations, and in 17 studies the researchers developed scales without an adequate description of the method used for their development and validation. Conclusion: The assessment of patients' expectations has been methodologically conducted in different ways. Until the completion of this integrative review, only two valid and reliable instruments had been used in three of the selected studies. DESCRIPTORSPatients; Spinal Fusion; Spine; General Surgery; Review.Instruments used in the assessment of expectation toward a spine surgery: an integrative review Instrumentos utilizados na avaliação da expectativa diante do tratamento cirúrgico da coluna vertebral: revisão integrativa Instrumentos utilizados en la evaluación de la expectación ante el tratamiento quirúrgico de la columna vertebral: revisión integrativa

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Section: Resultsmentioning

confidence: 76%

Section: Resultsmentioning

confidence: 99%

Section: Vilà-canet Et Almentioning

confidence: 99%

See 1 more Smart Citation

Instruments used in the assessment of expectation toward a spine surgery: an integrative review

Nepomuceno

Silveira

Dessotte

et al. 2016

Rev. esc. enferm. USP

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“…Interestingly, conflicting results have been reported regarding the importance of preoperative psychological distress for the outcome of spinal surgery [99,100,161]. Psychological distress may be a predictor of poor surgical outcome based on the NDI in patients with CR [13,99].…”

Section: Neck Disability In Patients With Cr and Scheduled For Surgermentioning

confidence: 92%

“…Symptom duration was not associated with the 6 months outcomes with the exception of a weak association between arm pain duration and NDI (Spearman correlation, r= 0.17, p = 0.05). In addition, the influence of preoperative pain duration on surgical outcomes is uncertain [3,161,181,182], and the longer preoperative symptom duration in patients who received SPT was not expected to have influenced the results.…”

Section: Methodsmentioning

confidence: 99%

Neck disability in patients with cervical radiculopathy and evaluation of structured postoperative physiotherapy

Wibault¹

2015

Linköping University Medical Dissertations

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Non-surgical and surgical approaches to treatment are used in patients with cervical radiculopathy (CR) due to disc disease. Overall, good effects of surgery have been reported on arm pain and neurological symptoms. However, the effects on neck functioning are more uncertain. Studies have shown persistent activity limitations; participation restrictions; and impairments in neck-related body functions after surgery. Structured physiotherapy combining neck-specific exercises with a behavioural approach has been suggested as treatment before as well as after surgery to improve clinical outcomes in patients with CR. Randomized clinical trials of postoperative physiotherapy to inform evidence-based clinical guidelines for the treatment of patients with CR are lacking. The overall aim of the thesis was to investigate the additional benefit of structured postoperative physiotherapy combining neck-specific exercises with a behavioural approach compared to standard postoperative approach in patients with CR. A further aim was to evaluate the contribution of different aspects of neck-related body functions and mental functions on preoperative neck disability in these patients. A total of 202 patients with CR who were scheduled for surgery were recruited, and randomized preoperatively to either structured postoperative physiotherapy, or standard postoperative approach. Standard postoperative approach was in accordance with Swedish postoperative care, and may have included pragmatic physiotherapy after surgery when needed. Patients were evaluated with a set of questionnaires and clinical examinations before surgery and at 3 and 6 months after surgery. Outcomes included patient-reported measures of pain, neck functioning, global outcome, clinical evaluation of neckrelated body functions, self-efficacy and coping strategies, as well as expectation fulfilment and enablement. Differences between treatment groups were investigated in complete case and per-protocol approaches (Paper III & IV). A sub-sample of patients with CR who were scheduled for surgery were also compared with neck-healthy individuals for assessment of head repositioning accuracy with a cervical range of motion device (Paper I). In patients with CR who were scheduled for surgery, associations between preoperative measures of neck-related body functions, mental functions, and other contextual factors with patientreported neck disability were studied (Paper II). With the exception of greater expectation fulfilment in patients who received structured postoperative physiotherapy (p = 0.01), there were no differences between the treatment groups in outcomes at 6 months after surgery. There were no differences reported for changes in outcomes from before surgery to 6 months after surgery between the groups, but all outcomes significantly improved from baseline in both groups (p<0.001) (Paper III & IV). However, global outcome and frequency of neck pain improved during the postoperative period only in patients who received structured postoperative physiot...

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Probing the mechanisms underpinning recovery in post‐surgical patients with cervical radiculopathy using Bayesian networks

Liew

Peolsson

Scutari

et al. 2020

European Journal of Pain

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Eur J Pain. 2020;24:909-920. wileyonlinelibrary.com/journal/ejp | 909 Abstract Background: Rehabilitation approaches should be based on an understanding of the mechanisms underpinning functional recovery. Yet, the mediators that drive an improvement in post-surgical pain-related disability in individuals with cervical radiculopathy (CR) are unknown. The aim of the present study is to use Bayesian networks (BN) to learn the probabilistic relationships between physical and psychological factors, and pain-related disability in CR. Methods: We analysed a prospective cohort dataset of 201 post-surgical individuals withCR. In all, 15 variables were used to build a BN model: age, sex, neck muscle endurance, neck range of motion, neck proprioception, hand grip strength, self-efficacy, catastrophizing, depression, somatic perception, arm pain intensity, neck pain intensity and disability. Results: A one point increase in a change of self-efficacy at 6 months was associated with a 0.09 point decrease in a change in disability at 12 months (t = −64.09, p < .001). Two pathways led to a change in disability: a direct path leading from a change in self-efficacy at 6 months to disability, and an indirect path which was mediated by neck and arm pain intensity changes at 6 and 12 months. Conclusions: This is the first study to apply BN modelling to understand the mechanisms of recovery in post-surgical individuals with CR. Improvements in painrelated disability was directly and indirectly driven by changes in self-efficacy levels. |

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Factors Affecting the Outcome of Surgical Versus Nonsurgical Treatment of Cervical Radiculopathy

Cited by 28 publications

References 18 publications

Instruments used in the assessment of expectation toward a spine surgery: an integrative review

Instruments used in the assessment of expectation toward a spine surgery: an integrative review

Neck disability in patients with cervical radiculopathy and evaluation of structured postoperative physiotherapy

Probing the mechanisms underpinning recovery in post‐surgical patients with cervical radiculopathy using Bayesian networks

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