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Does neck pain as chief complaint influence the outcome of cervical total disc replacement?

  • S. FinkenstaedtEmail author
  • A. F. Mannion
  • T. F. Fekete
  • D. Haschtmann
  • F. S. Kleinstueck
  • U. Mutter
  • H. J. Becker
  • D. Bellut
  • F. Porchet
Original article

Abstract

Purpose

We investigated whether outcomes after cervical total disc replacement (cTDR) are influenced by preoperative neck pain as the chief complaint.

Methods

This was a retrospective study using data in our local spine surgery outcomes database, linked to EUROSPINE Spine Tango Registry. Patients completed questionnaires at baseline enquiring about the “chief complaint” [neck pain (NP), arm/shoulder pain (AP) or neurological deficits (ND)] and including the Core Outcome Measures Index (COMI); these were completed again at 24 months postoperatively, along with a rating of “global treatment outcome” (on a five-point scale, later dichotomized as “good” or “poor”). Differences in outcomes between the groups were examined using ANOVA. Multivariable regression analysis examined the effect of the chief pain location on 24-month outcomes, controlling for age, gender, comorbidity, baseline pain and COMI scores.

Results

One hundred and fifty-nine consecutive patients were included, with a chief complaint of NP in 31%, AP in 38% and ND in 31%. The chief complaint groups did not differ in relation to their baseline COMI scores or their reductions in score from before surgery to 24 months after surgery (reduction: NP group, 4.4 ± 2.9 points; AP group, 4.7 ± 2.7; ND group, 4.3 ± 2.9; p = 0.78). Similarly, the percentage of patients reporting a “good global treatment outcome” at 24 months postoperatively did not differ between the groups (NP, 79%; AP, 77%; ND, 85%; p  = 0.64). The findings were consistent when controlling for possible confounders in multiple regression.

Conclusions

Having neck pain as opposed to arm pain or neurological deficits as preoperative chief complaint had no significant impact on clinical outcome after cTDR.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

Keywords

Neck pain Cervical total disc replacement cTDR Cervical arthroplasty 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Supplementary material

586_2019_6052_MOESM1_ESM.pptx (329 kb)
Supplementary file1 (PPTX 329 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • S. Finkenstaedt
    • 1
    Email author
  • A. F. Mannion
    • 1
  • T. F. Fekete
    • 1
  • D. Haschtmann
    • 1
  • F. S. Kleinstueck
    • 1
  • U. Mutter
    • 1
  • H. J. Becker
    • 1
  • D. Bellut
    • 1
  • F. Porchet
    • 1
  1. 1.Spine CenterSchulthess ClinicZurichSwitzerland

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