Single-level degenerative cervical disc disease and driving disability: results from a prospective, randomized trial.
Study Design Post hoc analysis of prospective, randomized trial. Objective To investigate the disability associated with driving and single-level degenerative, cervical disc disease and to investigate the effect of surgery on driving disability. Methods Post hoc analysis of data obtained from three sites participating in a multicenter, randomized, controlled trial comparing cervical disc arthroplasty (TDA) with anterior cervical discectomy and fusion (ACDF). The driving subscale of the Neck Disability Index (NDI) was analyzed for all patients. A dichotomous severity score was created from the NDI. Statistical comparisons were made within and between groups. Results Two-year follow-up was available for 118/135 (87%) patients. One half of the study population (49.6%) reported moderate or severe preoperative driving difficulty. This disability associated with driving was similar among the two groups (ACDF: 2.5 ± 1.1, TDA: 2.6 ± 1.0, p = 0.646). The majority of patients showed improvement, with no or little driving disability, at the sixth postoperative week (ACDF: 75%, TDA: 90%, p = 0.073). At no follow-up point did a difference exist between groups according to the severity index. Conclusions Many patients suffering from radiculopathy or myelopathy from cervical disc disease are limited in their ability to operate an automobile. Following anterior cervical spine surgery, most patients are able to return to comfortable driving at 6 weeks.
Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, United States.
Michael P
MP
Kelly
Orthopaedic Associates PA, Duncan, South Carolina, United States.
M David
MD
Mitchell
Oregon Neurosurgery Specialists, Springfield, Oregon, United States.
Robert J
RJ
Hacker
Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, United States.
K Daniel
KD
Riew
Indiana Spine Group, Carmel, Indianapolis, United States.
Rick C
RC
Sasso
arthroplasty; cervical; driving; fusion; herniation; randomized controlled trial; spondylosis