title: Are patient-reported outcomes predictive of patient satisfaction 5 years after anterior cervical spine surgery?
abstract: Patient satisfaction is becoming an increasing common proxy for surgical quality; however, the correlation between patient satisfaction and surgical outcomes 2 and 5 years after anterior cervical surgery has not been evaluated.
  
  
  
  The study aimed to determine if patient satisfaction is predicted by improvement in patient-reported outcomes (PRO) 2 and 5 years after anterior cervical spine surgery.
  
  
  
  This is a retrospective analysis of prospectively collected data.
  
  
  
  The sample included patients enrolled in the Food and Drug Administration investigational device exemption clinical trial comparing total disc replacement with Mobi-C cervical artificial disc and anterior cervical discectomy and fusion.
  
  
  
  The outcome measures were visual analog scale (VAS) neck pain score, Neck Disability Index (NDI), and Short-Form 12-Item scores, as well as patient satisfaction.
  
  
  
  Receiver operating characteristic curves were used to determine if improvement in different PRO metrics can accurately identify patient satisfaction. Additionally, a logistic regression analysis was performed on the results at 24 months and 60 months to identify independent predictors of patient satisfaction. This research was supported by LDR (Zimmer Biomet) 13785 Research Boulevard - Suite 200 Austin, TX 78750.
  
  
  
  Data were available for 512 patients at 60 months. At 24 months postoperatively, NDI score improvement (area under the curve [AUC]=0.806), absolute NDI score (AUC=0.823), and absolute VAS neck pain score (AUC=0.808) were all excellent predictors of patient satisfaction. At 60 months postoperatively, NDI score improvement (AUC=0.815), absolute NDI score (AUC=0.839), VAS neck pain score improvement (AUC=0.803), and absolute VAS neck pain score (AUC=0.861) were all excellent predictors of patient satisfaction.
  
  
  
  In patients undergoing one- and two-level anterior cervical spine surgery, between 2 and 5 years postoperatively, patient satisfaction is significantly predicted by PROs, including the VAS neck score and the NDI.
authors.affiliation: Department of Orthopaedic Surgery, The Rothman Institute, Thomas Jefferson University, 925 Chestnut St, 5th Floor, Philadelphia, PA 19107, USA. Electronic address: gregdschroeder@gmail.com.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Schroeder
authors.affiliation: Department of Neurosurgery, Carolina Neurosurgery & Spine Associates, Carolinas Medical Center, 225 Baldwin Ave, Charlotte, NC 28204, USA.
authors.forename: Dom
authors.initials: D
authors.lastname: Coric
authors.affiliation: Department of Orthopaedic Surgery, The Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA.
authors.forename: Han Jo
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, The Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA.
authors.forename: Todd J
authors.initials: TJ
authors.lastname: Albert
authors.affiliation: Department of Orthopaedic Surgery, The Rothman Institute, Thomas Jefferson University, 925 Chestnut St, 5th Floor, Philadelphia, PA 19107, USA.
authors.forename: Kris E
authors.initials: KE
authors.lastname: Radcliff
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery; D017586:Diskectomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D013123:Spinal Fusion / Q000009:adverse effects* / Q000379:methods; D059145:Total Disc Replacement / Q000009:adverse effects* / Q000379:methods
keywords: Anterior cervical discectomy and fusion; Cervical disc replacement; Cervical myelopathy; Cervical radiculopathy; Cervical spine surgery; Heath-related quality of life; MobiC; Neck pain; Patient satisfaction