The Clinical journal of pain · 2012
Patient satisfaction after anterior cervical discectomy and fusion is primarily driven by relieving pain.
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Hessler Christian, Boysen Katharina, Regelsberger Jan, Vettorazzi Eik, Winkler Dietrich, Westphal Manfred
Аннотация
OBJECTIVES: A prospective follow-up study of patients with anterior cervical discectomy and fusion (ACDF) for single-level cervical disc disease was conducted to determine the extent of impact of pain, sensory function, motor function, and range of motion (ROM) of the neck on patient satisfaction after ACDF.
METHODS: A total of 67 ACDF patients were monitored by clinical examination (pain, motor function, sensory function, and ROM in the neck) preoperatively and at follow-up (mean, 217 d after surgery; range, 198 to 232 d) and by a satisfactory questionnaire (SQ) at follow-up only. According to the SQs, 4 patient groups were characterized. Inside each patient group for each examination parameter, the percentage of patients who showed improved, unchanged, or worsened clinical results was analyzed.
RESULTS: Patient satisfaction was found to depend primarily on the improvement in pain (P=0.001). The development of motor function (P=0.056), sensory function (P=0.225), and ROM of the neck (P=0.565) did not demonstrate significant correlation with patient satisfaction. The Numerical Rating Scale score decreased from 6.2 before surgery to 2.1 on follow-up, whereas the level of analgesic use (World Health Organization scheme) decreased from 1.9 to 0.3.
DISCUSSION: Improvement in pain seemed to be most important aspect in ACDF patients regarding the subjective SQ. Therefore, we strongly recommend focusing on pain-reducing therapies when choosing treatment for these patients during the postoperative period.
METHODS: A total of 67 ACDF patients were monitored by clinical examination (pain, motor function, sensory function, and ROM in the neck) preoperatively and at follow-up (mean, 217 d after surgery; range, 198 to 232 d) and by a satisfactory questionnaire (SQ) at follow-up only. According to the SQs, 4 patient groups were characterized. Inside each patient group for each examination parameter, the percentage of patients who showed improved, unchanged, or worsened clinical results was analyzed.
RESULTS: Patient satisfaction was found to depend primarily on the improvement in pain (P=0.001). The development of motor function (P=0.056), sensory function (P=0.225), and ROM of the neck (P=0.565) did not demonstrate significant correlation with patient satisfaction. The Numerical Rating Scale score decreased from 6.2 before surgery to 2.1 on follow-up, whereas the level of analgesic use (World Health Organization scheme) decreased from 1.9 to 0.3.
DISCUSSION: Improvement in pain seemed to be most important aspect in ACDF patients regarding the subjective SQ. Therefore, we strongly recommend focusing on pain-reducing therapies when choosing treatment for these patients during the postoperative period.
Предметные рубрики MeSH
AdultAgedAged, 80 and overAnalgesicsAnalgesics, OpioidArmCervical VertebraeDiskectomyFemaleFollow-Up StudiesHumansIntraoperative ComplicationsMaleMiddle AgedMovementNeck PainPain ManagementPain MeasurementPatient SatisfactionPostoperative CarePostoperative ComplicationsRange of Motion, ArticularSensationSpinal FusionSurveys and QuestionnairesTreatment OutcomeYoung Adult