Predictors of patient satisfaction following anterior cervical discectomy and fusion for cervical radiculopathy.

OBJECTIVE

To evaluate whether preoperative patient-reported outcome measures (PROMs) and immediate postoperative arm pain improvement can predict patient satisfaction following anterior cervical spine surgery.

METHODS

A retrospective analysis of prospectively collected data from 193 patients with cervical radiculopathy undergoing surgery at Aarhus University Hospital was performed. Standardized questionnaires were used to assess demographics, clinical outcomes and complications preoperatively, postoperatively and at 1-year follow-up. PROMs covered Visual Analogue Scale for arm pain (VAS-AP) and neck pain (VAS-NP), Neck Disability Index (NDI), EQ-5D 3-level version (EQ-5D-3L), and satisfaction. Immediate upper extremity pain status was assembled from medical records.

RESULTS

PROMs significantly improved (p < 0.001) and most patients (66%) were satisfied with the surgical result at follow-up. Complications and complaints occurred in 3.6% intraoperatively, 1.5% postoperatively in-hospital, and 43% postoperatively post-discharge. Patients with a symptom duration exceeding 24 months had significantly decreased odds of being satisfied compared to patients with a symptom duration less than 3 months (OR: 0.32, 95% CI: 0.10-0.98, p = 0.046). Neither baseline PROMs nor immediate pain improvement significantly predicted patient satisfaction. Despite being non-significant, patients experiencing immediate pain improvement had increased odds of being satisfied compared to patients not experiencing immediate improvement (OR: 1.62, 95% CI: 0.65-4.05).

CONCLUSIONS

Prolonged symptom duration and immediate pain improvement may have an impact on patient satisfaction.