[ NEWS - SPINE ]
98 % of Cervical Patients Drive Within 16 days Postop
Cervical spine patients do well after surgery and in terms of outcomes that are most relevant to the patients themselves . Indeed , this new study raised an important question : Do non-patient reported outcome measures have a role in post-op evaluation systems ? If so , which ones can deliver relevant data and how valid , based on objective study , can they be ?
A team from New York City-based Hospital for Special Surgery and Weill Cornell Medicine tackled this intriguing question in a new study , “ Recovery Kinetics After Cervical Spine Surgery ,” which appeared in the December 15 , 2023 edition of Spine .
First author Tejas Subramanian , B . E ., a third-year medical student at Weill Cornell Medical , explained the team ’ s rationale and hypothesis for the study to OTW , “ Currently most of the counseling and pre-operative expectations are based on individual practitioners ’ experience and a ‘ best guess ’ as to how patients are going to do . This is , of course , useful and helpful to patients in most instances but it can be difficult to answer these questions in a data-driven way .”
“ Because there was surprisingly little data on this topic in the literature , we wanted to introduce our experience to help frame the conversation for providers across the country . Of course , there will be some variability between doctors ( for example , based on their comfort level with immobilization after surgery or patients-specific factors like bone quality , etc .) but we are hoping that the data we presented can help bring consistency to the pre-operative counseling for patients undergoing cervical surgery .”
The study enrolled 140 patients , of whom 70 were being treated with either anterior cervical discectomy and fusion ( ACDF ) and 70 were treated with cervical disk replacement ( CDR ). To measure outcomes , the team collected data on days to return to driving , return to work and days of opioid use after surgery .
Here is what the researchers documented :
• 98.2 % of ACDF patients and 98 % of CDR patients returned to driving in 16 and 12 days , respectively ;
• 85.7 % of ACDF patients and 90.9 % of CDR patients returned to work in 16 and 14 days ; and
• 98.3 % of ACDF patients and 98.3 % of CDR patients discontinued opioids in a median of 7 and 6 days .
“ As a field , we have focused on patient-reported outcomes and disability for the past several years ,” stated Subramanian to OTW . “ This is critical , of course , and has helped advance our field and has established the
value of spine procedures . While this remains important to our patients , ability is as important as disability , and I think that is something we are now starting to realize .”
“ We are just more familiar with the language of complications and pain scores , but patients care deeply about their recovery from surgery and return to specific activities like driving , work , etc .”
“ I think discussing a return to these activities is something we have not focused on enough as a field and I hope this paper and others published by our group serve as a framework for some of those discussions .”
“ I think the most interesting finding was just how quickly patients are able to get back to most activities after these procedures ; 98 % of patients were driving and almost 90 % were working by 16 days . Additionally , we found that patients recover in a similar fashion after ACDF and CDR .”
“ We need to continue to work on defining return to activities to help our patients get a sense for what they need to do to prepare for surgery and when they can return to specific activities . Our next focus is to look at cervical and lumbar patients and how they return to more athletic pursuits ( sports , etc .). I would also love to see similar manuscripts or data from other institutions so that we could have more generalizable data for providers to access .” — EH
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