Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.
Clin Spine Surg. 2023 Oct 1;36(8):310-316. doi: 10.1097/BSD.0000000000001459. Epub 2023 Apr 13.
STUDY DESIGN: Retrospective review. OBJECTIVE: We aim to elucidate the potential relationship between neck disability index (NDI) and outcomes following cervical disk replacement (CDR). SUMMARY OF BACKGROUND DATA: The use of preoperative disability scores as predictors of outcomes following spine surgery has previously been studied, yet no literature has been published regarding its use in CDR. METHODS: A retrospective database of a single orthopedic spine surgeon was searched for single-level CDR patients with preoperative NDI scores, excluding those with trauma, infection, or malignancy. Patients were separated into 2 cohorts by NDI score: Mild-Moderately Disabled (MD) (NDI<50) and Severely Disabled (NDI≥50). Patient-reported outcome measures were collected and compared within and between groups up to 1 year postoperatively and included Patient-reported Outcome Measurement Information System Physical Function, 12-Item Short Form (SF-12) Physical Component Score and Mental Component Score, visual analog scale (VAS) neck and arm pain, and NDI. MCID achievement rates were compared between the groups. RESULTS: All PROM scores significantly improved for both cohorts at one or more postoperative time points compared with preoperative baseline ( P ≤0.049, all), with the exception of SF-12 Mental Component Score, which only significantly improved in the MD cohort at 2 postoperative points ( P ≤0.007, both). Between groups, the MD cohort reported significantly superior scores at one or more time points for all studied patient-reported outcome measures ( P ≤0.047, all). MCID achievement rate did not significantly vary for any outcome at any time between cohorts. CONCLUSION: Regardless of preoperative disability, both groups reported improvement in physical function, pain, and disability scores following CDR. While not finding significance, patients with severe disability preoperatively consistently demonstrated higher minimal clinically important difference achievement in NDI. These data do not promote the use of NDI as a prognostic factor for outcomes following CDR. Further study with larger patient populations may be useful to clarify this potential relationship.
研究设计：回顾性研究。 目的：我们旨在阐明颈椎间盘置换术（CDR）后颈部残疾指数（NDI）与结果之间的潜在关系。 背景数据概要：先前已经研究了使用术前残疾评分作为脊柱手术后结果的预测因子，但尚未有关于其在 CDR 中的应用的文献发表。 方法：搜索一位骨科脊柱外科医生的回顾性数据库，寻找具有术前 NDI 评分的单节段 CDR 患者，排除创伤、感染或恶性肿瘤患者。患者根据 NDI 评分分为 2 组：轻度-中度残疾（MD）（NDI<50）和重度残疾（NDI≥50）。收集并比较了患者报告的结果测量指标，包括术后 1 年内的患者报告的测量信息系统物理功能、12 项简短表格（SF-12）物理成分评分和心理成分评分、视觉模拟量表（VAS）颈部和手臂疼痛以及 NDI。比较了两组之间的 MCID 达标率。 结果：与术前基线相比，两组在一个或多个术后时间点的所有 PROM 评分均显著改善（P≤0.049，全部），SF-12 心理成分评分除外，仅在 MD 组在两个术后点显著改善（P≤0.007，全部）。在组间比较中，MD 组在一个或多个时间点报告的所有研究患者报告的结果测量指标的评分均显著优于其他组（P≤0.047，全部）。在任何时间点，两组之间的任何结果的 MCID 达标率均无显著差异。 结论：无论术前残疾程度如何，两组在 CDR 后均报告了身体功能、疼痛和残疾评分的改善。虽然没有发现显著差异，但术前严重残疾的患者在 NDI 中始终表现出更高的最小临床重要差异的达标率。这些数据不支持将 NDI 用作 CDR 后结果的预后因素。进一步的研究可能有助于阐明这种潜在的关系。
Clin Spine Surg. 2023-10-1
Clin Spine Surg. 2024-3-1
Cochrane Database Syst Rev. 2025-6-4
Curr Rev Musculoskelet Med. 2025-5-17
BMC Musculoskelet Disord. 2025-4-8
Zotero 插件