Surgical Treatment and Outcomes of Cervical Radiculopathy

Decker, Robert C.

doi:10.1016/j.pmr.2010.12.001

Cited by 7 publications

(4 citation statements)

References 60 publications

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“… 9 10 14 15 Previous studies have shown that ACDF leads to statistically and clinically significant (greater than MCID) postoperative outcomes. 1 2 3 4 5 However, few have focused on identifying the predictive factors for superior clinical outcomes following ACDF. Those studies that have been performed did not investigate the impact of psychosocial factors on the outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have demonstrated that anterior cervical diskectomy and fusion (ACDF) leads to significant improvements in quality-of-life (QOL) outcomes. 1 2 3 4 5 However, to maximize the success of surgery and reduce complications and poor outcomes, optimal patient selection of surgical candidates is imperative. Better understanding of the preoperative predictors of postoperative outcomes will improve the patient selection for these elective procedures and enable targeted strategies for patients at higher risk.…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Preoperative Depression and Health State on Quality-of-Life Outcomes after Anterior Cervical Diskectomy and Fusion

Alvin

Miller

Lubelski

et al. 2015

Global Spine Journal

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Study Design Retrospective cohort study. Objective We sought to assess the predictive value of preoperative depression and health state on 1-year quality-of-life outcomes after anterior cervical diskectomy and fusion (ACDF). Methods We analyzed 106 patients who underwent ACDF. All patients had either bilateral or unilateral cervical radiculopathy. Preoperative and 1-year postoperative health outcomes were assessed based on the visual analog scale, Pain Disability Questionnaire (PDQ), Patient Health Questionnaire (PHQ-9), and EuroQol-5 Dimensions (EQ-5D) questionnaire. Univariable and multivariate regression analyses were performed to assess for preoperative predictors of 1-year change in health status according to the EQ-5D. Results Compared with preoperative health states, the ACDF cohort showed statistically significant improved PDQ (78.5 versus 57.9), PHQ-9 (9.7 versus 5.3), and EQ-5D (0.55 versus 0.68) scores at 1 year postoperatively and surpassed the minimum clinically important difference for the EQ-5D of 0.1 units (all p ≤ 0.01). Multivariate linear regression indicated that anxiolytic use and higher EQ-5D preoperative scores were associated with less 1-year postoperative improvement in health status. Although not statistically significant, clinically important effects of preoperative depression, as measured by the PHQ-9, were observed on postoperative QOL outcome (−0.006, 95% confidence interval −0.014 to 0.001). Conclusions Of patients who undergo ACDF with similar preoperative QOL health states, those with a greater degree of depression may have lower improvements in postoperative QOL compared with those with less depression. Patients with anxiety and better preoperative health states also attain less 1-year QOL improvements.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Impact of Preoperative Depression and Health State on Quality-of-Life Outcomes after Anterior Cervical Diskectomy and Fusion

Alvin

Miller

Lubelski

et al. 2015

Global Spine Journal

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“…CDH is approached anteriorly or posteriorly. The surgical outcomes of CDH have been reported to be successful in terms of clinical and radiological measures [ 3 4 ]. To date, however, little information has been available on the surgical outcomes of deltoid palsy due to CDH, because there are relatively few cases of deltoid palsy due to CDH.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Factors for Postsurgical Recovery of Deltoid Palsy due to Cervical Disc Herniations

et al. 2015

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Study DesignRetrospective multicenter study.PurposeWe aimed to investigate prognostic factors affecting postsurgical recovery of deltoid palsy due to cervical disc herniation (CDH).Overview of LiteratureLittle information is available about prognostic factors affecting postsurgical recovery of deltoid palsy due to CDH.MethodsSixty-one patients with CDH causing deltoid palsy (less than grade 3) were included in this study: 35 soft discs and 26 hard discs. Average duration of preoperative deltoid palsy was 11.9 weeks. Thirty-two patients underwent single-level surgery, 22 two-level, four three-level, and three four-level. Patients with accompanying myelopathy, shoulder diseases, or peripheral neuropathy were excluded from the study.ResultsDeltoid palsy (2.4 grades vs. 4.5 grades, p<0.001) and radiculopathy (6.4 points vs. 2.1 points, p<0.001) significantly improved after surgery. Thirty-six of 61 patients (59%) achieved full recovery (grade 5) of deltoid palsy, with an average time of 8.4 weeks. Longer duration of preoperative deltoid palsy and more severe radiculopathy negatively affected the degree of improvement in deltoid palsy. Age, gender, number of surgery level, and disc type did not affect the degree of improvement of deltoid palsy. Contrary to our expectations, severity of preoperative deltoid palsy did not affect the degree of improvement. Due to the shorter duration of preoperative deltoid palsy, in the context of rapid referral, early surgical decompression resulted in significant recovery of more severe grades (grade 0 or 1) of deltoid palsy compared to grade 2 or 3 deltoid palsy.ConclusionsEarly surgical decompression significantly improved deltoid palsy caused by CDH, irrespective of age, gender, number of surgery level, and disc type. However, longer duration of deltoid palsy and more severe intensity of preoperative radiating pain were associated with less improvement of deltoid palsy postoperatively.

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“…The treatment of CR can be divided into conservative and surgical treatment methods. 30,31 Surgical treatment options contain several different methods and are generally considered in the absence of success with conservative treatment. 32 The pool of conservative treatment methods for CR includes different manual and physical therapies as well as oral or invasive application of anti-inflammatory medication.…”

Section: Introductionmentioning

confidence: 99%

Relationship of Modic Changes, Disk Herniation Morphology, and Axial Location to Outcomes in Symptomatic Cervical Disk Herniation Patients Treated With High-Velocity, Low-Amplitude Spinal Manipulation: A Prospective Study

Kressig

Peterson

McChurch

et al. 2016

Journal of Manipulative and Physiological Therapeutics

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Surgical Treatment and Outcomes of Cervical Radiculopathy

Cited by 7 publications

References 60 publications

The Impact of Preoperative Depression and Health State on Quality-of-Life Outcomes after Anterior Cervical Diskectomy and Fusion

The Impact of Preoperative Depression and Health State on Quality-of-Life Outcomes after Anterior Cervical Diskectomy and Fusion

Prognostic Factors for Postsurgical Recovery of Deltoid Palsy due to Cervical Disc Herniations

Relationship of Modic Changes, Disk Herniation Morphology, and Axial Location to Outcomes in Symptomatic Cervical Disk Herniation Patients Treated With High-Velocity, Low-Amplitude Spinal Manipulation: A Prospective Study

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