Impact of Predominant Arm Pain vs Neck Pain on 12-Month Outcomes Following Elective Cervical Spine Surgery: Analysis From the Quality Outcomes Database (QOD)

Abstract

INTRODUCTION: The impact of the type of pain presentation on outcomes of spine surgery remains elusive. The severity of symptoms is a critical determinant for decision to operate among such patients. Herein, we present an analysis of the impact of predominant symptom location (arm pain vs neck pain) on postoperative improvement in patient reported outcomes. METHODS: TheQualityOutcomesDatabase (QOD) cervical spine registry was queried for patients undergoing 1 to 2 level ACDF for degenerative spine disease. Multivariable (MV) regression was performed to assess the impact of predominant pain location (arm pain vs neck pain vs equal arm and neck pain) on the following 12 mo outcomes following surgery-NASS satisfaction, Neck Disability Index (NDI) and return to work. RESULTS: A total of 9277 patients were included in the final analysis. Of these, 18.4% (n = 1705) presented with predominant arm pain, 32.3% (n = 2994) presented with predominant neck pain, and 49.3% (n = 4578) presented with equal neck and arm pain. On MV analysis, patients with predominant neck pain were found to have lower odds of being satisfied at 1 yr following surgery (OR = 0.73, CI: 0.62-0.98, P