Predictive factors for arm pain, neck pain, neck specific disability and health after anterior cervical decompression and fusion.
BACKGROUND
Predictive factors for a low arm and neck pain, and good health after anterior cervical decompression and fusion (ACDF) with a cervical carbon fibre intervertebral fusion cage (CIFC) are still lacking.


METHODS
A prospective consecutive study to investigate which preoperative factors that could predict a good outcome with regard to arm pain, neck pain, Neck Disability Index (NDI) and general health three years after ACDF with CIFC was conducted. Thirty-four patients were included before surgery. Measurements took place the day before, six months, one year and three years after ACDF.


RESULTS
In multivariate analysis, to be a non-smoker before surgery was the most important factor for a low postoperative arm pain, a low pain frequency was the most important factor for low postoperative neck pain, normal rating on Distress and Risk Assessment Method (DRAM) was the most important factor for high function on NDI and a low initial pain intensity was the most important factor for good postoperative health. For all outcome variables a normal rating on DRAM was an important factor for a good outcome.


CONCLUSIONS
Non-smoking, a low pain level and normal rating on DRAM were the best preoperative predictors of a good outcome in ACDF. Inclusion criteria for surgery should be based on a bio psychosocial model and DRAM seems to be useful for including the traditional inclusion criteria.
Peolsson
A
A
Division of Physiotherapy, Faculty of Health Sciences, Department of Health and Society, Linköping University, Linköping, and Department of Neuro-Orthopedic Surgery, Ryhov Hospital, Jönköping, Sweden. Anneli.Peolsson@ihs.liu.se
Vavruch
L
L
Oberg
B
B
D000328:Adult; D000368:Aged; D015984:Causality; D002574:Cervical Vertebrae / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D019299:Decompression, Surgical / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D004185:Disability Evaluation; D017586:Diskectomy / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000453:epidemiology / Q000503:physiopathology; D010147:Pain Measurement / Q000523:psychology; D010149:Postoperative Pain / Q000453:epidemiology* / Q000503:physiopathology; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D011843:Radiculopathy / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013123:Spinal Fusion / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D016896:Treatment Outcome