Changes in pain and disability after cervical spinal surgery

Abstract

The aim of this study was to monitor changes in functioning and pain after cervical spinal surgery. It was already known that both pain and functional ability change after surgery, and that the direction of these changes is usually positive. However, the magnitude and developmental trajectories of these changes in different patient groups had been studied very little. In this study, at two-year follow-up, the changes in functioning and pain after surgery were not uniform. Although in some patient groups neck pain was relieved, in other groups neck pain was still severe or had even worsened after surgery. Correspondingly, radiating pain in the upper extremities either improved throughout the follow-up or worsened after an initial improvement. The same uneven changes were seen in functioning, which improved among some patients, while in other groups it remained unchanged, either significantly reduced or relatively good throughout the follow-up. Sex, preoperative pain duration and body mass index were not related to the probability of belonging to a certain functioning level group. In terms of pain change, female sex and longer preoperative duration of pain predicted worse postoperative results. On average, overall functioning slightly decreased toward the end of follow-up. This study found that the different areas of functional capacity may show different changes after surgery. The results also suggest that even generally accepted and valid outcome measure of disability may behave slightly differently between sexes, as detection of functional restrictions was more accurate and sensitive among women. The different areas of functioning may have different levels of importance depending on the age and sex of respondents. The main result was that patients experience diverse patterns of recovery after cervical spinal surgery. These findings may have important implications for tailoring treatment plans based on individual patient characteristics.