Prevalence of Neck Pain in Patients with Degenerative Cervical Myelopathy and Short-Term Response After Operative Treatment: A Cohort Study of 664 Patients From 26 Global Sites.

STUDY DESIGN: Ambispective cohort study. OBJECTIVES: 1) To define the prevalence of neck pain in patients with degenerative cervical myelopathy (DCM). 2) To identify associated factors of preoperative neck pain in patients with DCM. 3) To assess the neck pain response to surgical intervention. METHODS: 757 patients with DCM were enrolled at 26 global sites from 2005 to 2011. A total of 664 patients had complete neck pain scores preoperatively (Neck Disability Index, NDI). The prevalence and severity of neck pain preoperatively and at the 6-months follow-up was summarized. Functional assessments of individuals with and without pain were compared. Associations of preoperative neck pain and related factors were evaluated. RESULTS: Preoperatively, 79.2% of patients reported neck pain while 20.8% had no neck pain. Of individuals with neck pain, 20.2% rated their pain as very mild, 27.9% as moderate, 19.6% as fairly severe, 9.6% as very severe and 1.9% as the worst imaginable. Functional status (mJOA), number of stenotic levels, age, and duration of symptoms did not significantly differ in patients with and without pain. Factors associated with the presence of neck pain were female gender, BMI ≥27 kg/m2, rheumatologic and gastrointestinal comorbidities, and age <57 years. Neck pain improved significantly from the preoperative examination to the 6-months postoperative follow-up (P < .0001). CONCLUSION: Here, we demonstrate a high prevalence of neck pain in patients with DCM as well as a link between gender, body weight, comorbidity and age. We highlight a significant reduction in neck pain 6 months after surgery.

Significant Predictors of Outcome Following Surgery for the Treatment of Degenerative Cervical Myelopathy: A Systematic Review of the Literature.

This systematic review aims to summarize important clinical predictors of outcomes in patients undergoing surgery for the treatment of degenerative cervical myelopathy. Based on the results of this article, patients with a longer duration of symptoms and more severe myelopathy are likely to have worse surgical outcomes. With respect to age, several studies have indicated that elderly patients are less likely to translate neurologic recovery into functional improvements. However, many other studies have failed to identify a significant association between age and outcomes. Finally, smoking status and presence of comorbidities may be important predictors of outcomes.