Acta Neurochirurgica

, Volume 157, Issue 10, pp 1807–1812 | Cite as

The Neck Disability Index (NDI) and its correlation with quality of life and mental health measures among patients with single-level cervical disc disease scheduled for surgery

  • J. SundsethEmail author
  • F. Kolstad
  • L. G. Johnsen
  • A. H. Pripp
  • O. P. Nygaard
  • H. Andresen
  • O. A. Fredriksli
  • E. Myrseth
  • M. Züchner
  • J. A. Zwart
Clinical Article - Spine



The Neck Disability Index (NDI) is widely used as a self-rated disability score in patients with cervical radiculopathy. The purpose of this study was to evaluate whether the NDI score correlated with other assessments of quality of life and mental health in a specific group of patients with single-level cervical disc disease and corresponding radiculopathy.


One hundred thirty-six patients were included in a prospective, randomized controlled clinical multicenter study on one-level anterior cervical discectomy with arthroplasty (ACDA) versus one-level anterior cervical discectomy with fusion (ACDF). The preoperative data were obtained at hospital admission 1 to 3 days prior to surgery. The NDI score was used as the dependent variable and correlation as well as regression analyses were conducted to assess the relationship with the short form-36, EuroQol-5Dimension-3 level and Hospital Anxiety and Depression Scale.


The mean age at inclusion was 44.1 years (SD ±7.0, range 26–59 years), of which 46.3 % were male. Mean NDI score was 48.6 (SD = 12.3, minimum 30 and maximum 88). Simple linear regression analysis demonstrated a significant correlation between NDI and the EuroQol-5Dimension-3 level [R = -0.64, 95 % confidence interval (CI) -30.1– -19.8, p < 0.001] and to a lesser extent between NDI and the short form-36 physical component summary [R = -0.49, 95 % CI (-1.10– -0.58), p < 0.001] and the short form-36 mental component summary [R = -0.25, 95 % CI (-0.47– -0-09), p = 0.004]. Regarding NDI and the Hospital Anxiety and Depression Scale, a significant correlation for depression was found [R = 0.26, 95 % CI (0.21–1.73), p = 0.01]. Multiple linear regression analysis showed a statistically significant and the strongest correlation between NDI and the independent variables in the following order: EuroQol-5Dimension-3 level [R = -0.64, 95 % CI (-23.5– -7.9), p <0.001], short form-36 physical component summary [R = -0.41, 95 % CI (-0.93– -0.23), p = 0.001] and short form-36 mental component summary [R = -0.36, 95 % CI (-0.53– -0.15), p = 0.001].


The results from the present study show that the NDI correlated significantly with a different quality of life and mental health measures among patients with single-level cervical disc disease and corresponding radiculopathy.


Cervical radiculopathy Neck Disability Index Quality of life Anxiety Depression 



The authors would like to thank Vigdis Skogli, Torun Gillebo, Jorund Roos, Camilla Seif and Monica Finkirk for efforts to convene the patients, coordination of investigations and follow-up of the study.

Conflict of interest

The study committee has received a grant from DePuy Synthes Spine (325 Paramount Drive Raynham, MA 02767) for the project to be completed. The study sponsor was not involved in the study design, conduct of the trial, or writing or review of the manuscript. The prostheses implanted were solely financed by the individual hospitals.


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Copyright information

© Springer-Verlag Wien 2015

Authors and Affiliations

  • J. Sundseth
    • 1
    • 2
    Email author
  • F. Kolstad
    • 1
  • L. G. Johnsen
    • 3
  • A. H. Pripp
    • 4
  • O. P. Nygaard
    • 5
    • 6
  • H. Andresen
    • 5
  • O. A. Fredriksli
    • 6
    • 7
  • E. Myrseth
    • 8
  • M. Züchner
    • 1
  • J. A. Zwart
    • 2
    • 9
  1. 1.Department of NeurosurgeryOslo University Hospital RikshospitaletOsloNorway
  2. 2.Institute of Clinical MedicineUniversity of OsloOsloNorway
  3. 3.Neuroclinic, Center of Spinal Disorder and Department of Orthopedic Surgery, Clinic of Orthopaedics and Rheumatology, St. Olavs HospitalTrondheim University HospitalTrondheimNorway
  4. 4.Department of Biostatistics, Epidemiology and Health EconomicsOslo University HospitalOsloNorway
  5. 5.National resource center for spinal disordersUniversity Hospital of Trondheim (St Olavs Hospital HF)TrondheimNorway
  6. 6.Department of NeurosurgeryUniversity Hospital of Trondheim (St Olavs Hospital HF)TrondheimNorway
  7. 7.University of TrondheimTrondheimNorway
  8. 8.Department of NeurosurgeryHaukeland University HospitalBergenNorway
  9. 9.Department of Neurology and FORMIOslo University Hospital UllevaalOsloNorway

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