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Health Outcome Assessment Before and After Anterior Cervical Discectomy and Fusion for Radiculopathy: A Prospective Analysis

Klein, Gregg R., MD*; Vaccaro, Alexander R., MD*†; Albert, Todd J., MD*†

Cervical Spine

Study Design. A prospective assessment, performed using the Health Status Questionnaire, of the outcomes for 28 patients with cervical radiculopathy treated with one- or two-level anterior cervical discectomy and fusion.

Objective. To assess patient outcome using the Health Status Questionnaire after one- or two-level anterior cervical discectomy and fusion.

Summary of Background Data. Although outcomes for many types of surgical procedures already have been evaluated, few have focused on the results of cervical surgery.

Methods. Before and after anterior cervical discectomy and fusion for cervical radiculopathy, 28 patients filled out the Health Status Questionnaire. The average follow-up interval was 21.8 months. There were 10 men and 18 women, with an average age of 44 years. All outcome instruments were graded for individual scores of general health, physical function, role limitation because of physical health problems, role limitation because of emotional problems, social function, mental health, bodily pain, and energy. Data were analyzed using the age (< 55 vs. > 55), worker’s compensation status, and education status of the patient. Preoperative and postoperative scores were compared for each subscale.

Results. Statistically significant improvements were found in postoperative scores for bodily pain (P < 0.001), vitality (P = 0.003), physical function (P = 0.01), role function/physical (P = 0.0003), and social function (P = 0.0004). No significant differences were found before and after surgery for three health scales: general health, mental health, and role function associated with emotional limitations. Age, educational status, and history of compensation litigation did not appear to affect outcome measures.

Conclusions. Although this is a preliminary report involving 28 patients, it would appear, based on the results of the Health Status Questionnaire, that anterior cervical discectomy and fusion performed on appropriately selected patients is a highly reliable surgical procedure for the management of cervical radiculopathy. Additional disease-specific questions may provide more sensitivity in evaluating radiculopathy after surgical and nonsurgical intervention.

From the *Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, and the †The Rothman Institute, Philadelphia, Pennsylvania.

Acknowledgment date: March 12, 1999.

First revision date: May 17, 1999.

Second revision date: June 16, 1999.

Acceptance date: July 15, 1999.

Address correspondence to

Todd J. Albert, MD

The Rothman Institute

925 Chestnut Street

Philadelphia, PA 19107

Device status category: 11.

Conflict of interest category: 12.

© 2000 Lippincott Williams & Wilkins, Inc.