P76 Skip laminectomy versus cervical laminectomy, an analysis of patient reported outcomes, spinal alignment and re-operation rates: the leeds spinal unit experience (2008–2016)

ObjectivesTo compare clinical, radiological and complication results between skip laminectomy and cervical laminectomy for posterior cervical decompression for cervical spondylotic myelopathy.DesignRetrospective single institution cohort study.SubjectsSubjects underwent primary skip or cervical laminectomy between 2008–2016.MethodsStatistical analysis compared pre- and post-operative differences in Visual Analogue Scale, Neck Disability Index and radiological differences in sagittal alignment of the vertebral bodies. Analysis of re-operation rates was performed.ResultsA total of 42 and 29 patients had skip and cervical laminectomy respectively. Median follow up was 32±23.1 (Range: 1–325) weeks. Post-operatively there was no difference in patient reported outcomes namely Visual Analogue Scale and Neck Disability Index between skip laminectomy and cervical laminectomy groups compared to pre-operatively (p=0.64, p=0.75). No difference was seen in sagittal alignment between both groups following surgery (p=0.65). Three patients (7.1%) in the skip laminectomy group and two patients (6.9%) in the cervical laminectomy group required revision surgery to the cervical spinal region at a different level to the original surgery. No patients needed further instrumentation.ConclusionsBoth skip laminectomy and cervical laminectomy appear to deliver similar outcomes with regards to patient reported outcomes, preserving sagittal alignment and re-operation rates over this short follow-up period.

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Use of zero-profile device for contiguous three-level anterior cervical discectomy and fusion: comparison with cage and plate construct

Journal of Neurosurgery Spine ◽

10.3171/2020.11.spine201319 ◽

2021 ◽

pp. 1-8

Author(s):

Zhipeng Chen ◽

Shuizhong Cen ◽

Jionglin Wu ◽

Rui Guo ◽

Zhenhua Liu ◽

...

Keyword(s):

Patient Reported Outcomes ◽

Sagittal Alignment ◽

Japanese Orthopaedic Association ◽

Neck Disability Index ◽

Patient Choice ◽

Adjacent Segment ◽

Radiographic Findings ◽

Significant Difference ◽

Patient Reported

OBJECTIVE The aim of this study was to compare a traditional cervical cage with a zero-profile (ZP) fixation device in patients who underwent three-level anterior cervical decompression and fusion (ACDF) in terms of patient-reported outcomes (visual analog scale [VAS], Japanese Orthopaedic Association [JOA], and Neck Disability Index [NDI] scores), radiographic findings (sagittal alignment 2 years after surgery and likelihood of fusion), and complications. METHODS This study was a retrospective case series. Between January 2012 and December 2016, 58 patients with cervical spondylotic myelopathy (CSM) who required three-level ACDF procedures, as identified by spinal surgeons, were treated with three-level ACDF and an anterior cage-plate construct (ACPC) (n = 38) or a three-level stand-alone ZP device (n = 20). On the basis of patient choice, patients were divided into two groups (ACPC group and ZP group). All patients completed a minimum of 2 years of follow-up. Patient-reported outcome scores included VAS, JOA, and NDI scores. The radiographic findings included sagittal alignment and likelihood of fusion 2 years after surgery. Data related to patient-reported outcomes and sagittal alignment were collected preoperatively, postoperatively, and at the final follow-up. Intraoperative and postoperative complications were also documented and analyzed. RESULTS The clinical outcomes, including VAS, JOA, and NDI scores, showed improvement in both groups, and no significant difference was observed between the two groups. Sagittal alignment and height of the fused segments were restored in all patients. However, the authors found no differences between the ZP and ACPC groups, and the groups exhibited similar fusion rates. The authors found no differences in complications, including dysphagia, adjacent-segment degeneration, and postoperative hematoma, between the groups. CONCLUSIONS Use of ZP implants yielded satisfactory long-term clinical and radiological outcomes that were similar to those of the standard ACPC. Additionally, the rates of complications between the groups were not significantly different. Although the best surgical option for multilevel CSM remains controversial, the results of this work suggest that ACDF with the ZP device is feasible, safe, and effective, even for multilevel CSM.

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A Novel Virtual Reality Technique (Cervigame®) Compared to Conventional Proprioceptive Training to Treat Neck Pain: A Randomized Controlled Trial

Journal of Biomedical Physics and Engineering ◽

10.31661/jbpe.v9i3jun.556 ◽

2019 ◽

Vol 9 (3Jun) ◽

Cited By ~ 1

Author(s):

I Rezaei ◽

M Razeghi ◽

S Ebrahimi ◽

S Kayedi ◽

A Rezaeian Zadeh

Keyword(s):

Virtual Reality ◽

Visual Analogue Scale ◽

Neck Pain ◽

Analogue Scale ◽

Controlled Trial ◽

Neck Disability Index ◽

Repeated Measure ◽

Balance Test ◽

Proprioceptive Training ◽

Neck Disability

Background: Despite the potential benefits of virtual reality technology in physical rehabilitation, only a few studies have evaluated the efficacy of this type of treatment in patients with neck pain.Objective: The aim of this study was to compare the effects of virtual reality training (VRT) versus conventional proprioceptive training (CPT) in patients with neck pain.Methods: Forty four participants with nonspecific chronic neck pain were randomly assigned to VRT or CPT in this assessor-blinded clinical trial. A novel videogame called Cervigame® was designed for VRT. It comprises of 50 stages divided into unidirectional and two-directional stages ordered from easy to hard. CPT consisted of eye-follow, gaze stability, eye-head coordination and position and movement sense training. Both groups completed 8 training sessions over 4 weeks. Visual analogue scale score, neck disability index and Y-balance test results were recorded at baseline, immediately after and 5 weeks post-intervention. Mixed repeated measure ANOVA was used to analyze differences between mean values for each variable at an alpha level of 0.05.Results: There were significant improvements in all variables in both groups immediately after and 5 weeks after the intervention. Greater improvements were observed in the visual analogue scale and neck disability index scores in VRT group, and the results for all directions in Y-balance test were similar in both groups. No side effects were reported.Conclusion: Improvements in neck pain and disability were greater in VRT than CPT group. Cervigame® is a potentially practical tool for rehabilitation in patients with neck pain.

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A Novel Virtual Reality Technique (Cervigame®) Compared to Conventional Proprioceptive Training to Treat Neck Pain: A Randomized Controlled Trial

Journal of Biomedical Physics and Engineering ◽

10.31661/jbpe.v0i0.556 ◽

2018 ◽

Author(s):

I Rezaei ◽

M Razeghi ◽

S Ebrahimi ◽

S Kayedi ◽

A Rezaeian Zadeh

Keyword(s):

Virtual Reality ◽

Visual Analogue Scale ◽

Neck Pain ◽

Analogue Scale ◽

Controlled Trial ◽

Neck Disability Index ◽

Repeated Measure ◽

Balance Test ◽

Proprioceptive Training ◽

Neck Disability

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Does Obesity Correlate With Worse Patient-Reported Outcomes Following Elective Anterior Cervical Discectomy and Fusion?

Neurosurgery ◽

10.1227/neu.0000000000001252 ◽

2016 ◽

Vol 79 (1) ◽

pp. 69-74 ◽

Cited By ~ 7

Author(s):

John A. Sielatycki ◽

Chotai Silky ◽

Kay Harrison ◽

David Stonko ◽

Matthew McGirt ◽

...

Keyword(s):

Scale Score ◽

Patient Reported Outcomes ◽

Minimal Clinically Important Difference ◽

Japanese Orthopaedic Association ◽

Neck Disability Index ◽

Japanese Orthopaedic Association Score ◽

Association Score ◽

Clinically Important Difference ◽

Patient Reported ◽

Neck Disability

Abstract BACKGROUND Studies have investigated the impact of obesity in thoracolumbar surgery; however, the effect of obesity on patient-reported outcomes (PROs) following anterior cervical discectomy and fusion (ACDF) is unknown. OBJECTIVE To examine the relationship between obesity and PROs following elective ACDF. METHODS Consecutive patients undergoing ACDF for degenerative conditions were evaluated. Patients were divided into groups with a body mass index ≥35. The EuroQol-5D, Short-Form 12 (SF-12), modified Japanese Orthopaedic Association score, and Neck Disability Index were used. Correlations between PROs and obesity were calculated at baseline and 1 year. RESULTS A total of 299 patients were included, with 80 obese (27%) and 219 nonobese (73%). patients At baseline, obesity was associated with worse myelopathy (modified Japanese Orthopaedic Association score: 10.7 vs 12.2, P = .01), general physical health (SF-12 physical component scale score: 28.7 vs 31.8, P = .02), and general mental health (SF-12 mental component scale score: 38.9 vs 42.3, P = .04). All PROs improved significantly following surgery in both groups. There was no difference in absolute scores and change scores for any PRO at 12 months following surgery. Furthermore, there was no difference in the percentage of patients achieving a minimal clinically important difference for the Neck Disability Index (52% vs 56%, P = .51) and no difference in patient satisfaction (85% vs 85%, P = .85) between groups. CONCLUSION Obesity was not associated with less improvement in PROs following ACDF. There was no difference in the proportion of patients satisfied with surgery and those achieving a minimal clinically important difference across all PROs. Obese patients may therefore achieve meaningful improvement following elective ACDF.

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High-Intensity Zones on MRI of the Cervical Spine in Patients: Epidemiology and Association With Pain and Disability

Global Spine Journal ◽

10.1177/2192568220966328 ◽

2020 ◽

pp. 219256822096632

Author(s):

Austin Q. Nguyen ◽

Garrett K. Harada ◽

Kayla L. Leverich ◽

Krishn Khanna ◽

Philip K. Louie ◽

...

Keyword(s):

Cohort Study ◽

Cervical Spine ◽

Clinical Significance ◽

Retrospective Cohort Study ◽

High Intensity ◽

Retrospective Cohort ◽

Patient Reported Outcomes ◽

Neck Disability Index ◽

Patient Reported ◽

Neck Disability

Study Design: Retrospective cohort study. Objectives: This study aimed to address the prevalence, distribution, and clinical significance of cervical high-intensity zones (HIZs) on magnetic resonance imaging (MRI) with respect to pain and other patient-reported outcomes in the setting of patients that will undergo an anterior cervical discectomy and fusion (ACDF) procedure. Methods: A retrospective cohort study of ACDF patients surgically treated at a single center from 2008 to 2015. Based on preoperative MRI, HIZ subtypes were identified as either traditional T2-hyperintense, T1-hypointense (“single-HIZs”), or combined T1- and T2-hyperintense (“dual-HIZs”), and their level-specific prevalence was assessed. Preoperative symptoms, patient-reported outcomes, and disc degeneration pathology were assessed in relation to HIZs and HIZ subtypes. Results: Of 861 patients, 58 demonstrated evidence of HIZs in the cervical spine (6.7%). Single-HIZs and dual-HIZs comprised 63.8% and 36.2% of the overall HIZs, respectively. HIZs found outside of the planned fusion segment reported better preoperative Neck Disability Index (NDI; P = .049) and Visual Analogue Scale (VAS) Arm ( P = .014) scores relative to patients without HIZs. Furthermore, patients with single-HIZs found inside the planned fusion segment had worse VAS Neck ( P = .045) and VAS Arm ( P = .010) scores. In general, dual-HIZ patients showed no significant differences across all clinical outcomes. Conclusions: This is the first study to evaluate the clinical significance of HIZs in the cervical spine, noting level-specific and clinical outcome–specific variations. Single-HIZs were associated with significantly more pain when located inside the fusion segment, while dual-HIZs showed no associations with patient-reported outcomes. The presence of single-HIZs may correlate with concurrent spinal pathologies and should be more closely evaluated.

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Secular changes in the progression of clinical markers and patient-reported outcomes in early rheumatoid arthritis

Rheumatology ◽

10.1093/rheumatology/kez635 ◽

2020 ◽

Vol 59 (9) ◽

pp. 2381-2391 ◽

Cited By ~ 3

Author(s):

Lewis Carpenter ◽

Elena Nikiphorou ◽

Patrick D W Kiely ◽

David A Walsh ◽

Adam Young ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Visual Analogue Scale ◽

Early Rheumatoid Arthritis ◽

Analogue Scale ◽

Patient Reported Outcomes ◽

Short Form ◽

Clinical Markers ◽

Short Form 36 ◽

Early Ra ◽

Patient Reported

Abstract Objectives To examine secular trends in the progression of clinical and patient-reported outcomes in early RA. Methods A total of 2701 patients recruited to the Early Rheumatoid Arthritis Study or Early Rheumatoid Arthritis Network with year of diagnosis from 1986 to 2011. The 5-year progression rates for patients diagnosed at different points in time were modelled using mixed-effects regression; 1990, 2002 and 2010, were compared. Clinical markers of disease included the 28-joint count DAS and the ESR. Patient-reported markers included the HAQ, visual analogue scale of pain and global health, and the Short-Form 36. Results Statistically significant improvements in both 28-joint count DAS and ESR were seen over the 5 years in patients diagnosed with RA compared with those diagnosed earlier. By 5 years, 59% of patients with diagnosis in 2010 were estimated to reach low disease activity compared with 48% with diagnosis in 2002 and 32% with diagnosis in 1990. Whilst HAQ demonstrated statistically significant improvements, these improvements were small, with similar proportions of patients achieving HAQ scores of ≤1.0 by 5 years with a diagnosis in 1990 compared with 2010. Levels of the visual analogue scale and the Mental Component Scores of the Short-Form 36 indicated similar, statistically non-significant levels over the 5 years, irrespective of year diagnosed. Conclusion This study demonstrates improvements in inflammatory markers over time in early RA, in line with improved treatment strategies. These have not translated into similar improvements in patient-reported outcomes relating to either physical or mental health.

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Transverse oscillatory pressure (TOP) in the management of cervical radiculopathy using visual analogue scale and neck disability index as outcome measures

Manual Therapy ◽

10.1016/j.math.2016.05.133 ◽

2016 ◽

Vol 25 ◽

pp. e81

Author(s):

A.O. Ojoawo

Keyword(s):

Visual Analogue Scale ◽

Outcome Measures ◽

Analogue Scale ◽

Neck Disability Index ◽

Cervical Radiculopathy ◽

Neck Disability ◽

Oscillatory Pressure

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Transcorporeal cervical foraminotomy: description of technique and results

Coluna/Columna ◽

10.1590/s1808-18512014130300r78 ◽

2014 ◽

Vol 13 (3) ◽

pp. 180-184

Author(s):

Guilherme Pereira Corrêa Meyer ◽

Gun Choi ◽

Amit Bandharkar ◽

Pil Sun Choi ◽

Sang Ho Lee ◽

...

Keyword(s):

Surgical Technique ◽

Analogue Scale ◽

Neck Disability Index ◽

Clinical Results ◽

Disc Height ◽

Significant Clinical Improvement ◽

Clinical Records ◽

Neck Disability ◽

Cervical Foraminotomy

OBJECTIVE: Retrospective analyses of 216 patients undergoing foraminal decompression with transcorporeal approach and review of the surgical technique. METHOD: 216 patients with minimum follow-up of 2 years and an average of 41.8 months were included in the study. The clinical records of these patients were reviewed for complications, NDI (neck disability index) and VAS (visual analogue scale). Pre and post-operative radiographs were used to evaluate the disc height. RESULTS: At the end of follow-up patients had significant clinical improvement with reduction of NDI of 88.3% and 86.5% and 68.3% of the VAS for neck and upper limb, respectively (p<0.05). A reduction of 8.8% of the disc height was observed without other complications associated (p<0.05). CONCLUSION: Radicular decompression through a transcorporeal approach is an alternative that provides good clinical results without the need for a fusion and with few complications.

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