Neck-related disability, headache, and pain intensity after anterior or posterior cervical decompression surgery in individuals with cervical radiculopathy and neck-related headache: a national registry-based study with 2-year follow-up.

Abstract

Approximately 50% of all individuals with cervical radiculopathy (CR) have headache, but knowledge on neck-related disability, headache, and pain aoof this study was to investigate and compare outcomes of ACDF and PCF regarding neck-related disability, headache, and neck and arm pain in individuals with CR and neck-related headache. This was a registry-based cohort study with prospectively collected data, including 2-year follow-up, using data from the Swedish Spine Registry (Swespine). All individuals with CR and neck-related headache registered in Swespine who underwent either ACDF (n = 2441) or PCF (n = 448) between January 2014 and March 2021 were included. Outcome measures were neck-related disability as measured by the Neck Disability Index (NDI), headache measured by the headache item of the NDI, and neck and arm pain intensity measured on an 11-point numeric rating scale. Patient-reported data were collected preoperatively and at 1- and 2-year follow-up evaluations. Surgeon-reported data regarding the operation were collected soon after the operation. Between- and within-group differences were analyzed for ACDF and PCF using a linear mixed model. Headache decreased to a greater extent preoperatively by the 2-year follow-up evaluation with PCF than with ACDF (p = 0.021). No other significant between-group differences were found at any follow-up. For all outcome measures, there were significant within-group improvements from preoperatively to both the 1- and 2-year follow-up evaluations after ACDF and PCF (p < 0.001). ACDF and PCF decreased headache in individuals with CR and neck-related headache, but PCF appeared to decrease headache more over time. Both interventions also resulted in similar improvements in neck-related disability and neck and arm pain.