High-impact chronic pain transition in surgical recipients with cervical spondylotic myelopathy.

dc.contributor.author

Cook, Chad E

dc.contributor.author

George, Steven Z

dc.contributor.author

Asher, Anthony L

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Bisson, Erica F

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Buchholz, Avery L

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Bydon, Mohamad

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Chan, Andrew K

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Haid, Regis W

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Mummaneni, Praveen V

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Park, Paul

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Shaffrey, Christopher I

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Than, Khoi D

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Tumialan, Luis M

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Wang, Michael Y

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Gottfried, Oren N

dc.date.accessioned

2023-06-16T15:18:24Z

dc.date.available

2023-06-16T15:18:24Z

dc.date.issued

2022-01

dc.date.updated

2023-06-16T15:18:24Z

dc.description.abstract

Objective

High-impact chronic pain (HICP) is a recently proposed metric that indicates the presence of a severe and troubling pain-related condition. Surgery for cervical spondylotic myelopathy (CSM) is designed to halt disease transition independent of chronic pain status. To date, the prevalence of HICP in individuals with CSM and their HICP transition from presurgery is unexplored. The authors sought to define HICP prevalence, transition, and outcomes in patients with CSM who underwent surgery and identify predictors of these HICP transition groups.

Methods

CSM surgical recipients were categorized as HICP at presurgery and 3 months if they exhibited pain that lasted 6-12 months or longer with at least one major activity restriction. HICP transition groups were categorized and evaluated for outcomes. Multivariate multinomial modeling was used to predict HICP transition categorization.

Results

A majority (56.1%) of individuals exhibited HICP preoperatively; this value declined to 15.9% at 3 months (71.6% reduction). The presence of HICP was also reflective of other self-reported outcomes at 3 and 12 months, as most demonstrated notable improvement. Higher severity in all categories of self-reported outcomes was related to a continued HICP condition at 3 months. Both social and biological factors predicted HICP translation, with social factors being predominant in transitioning to HICP (from none preoperatively).

Conclusions

Many individuals who received CSM surgery changed HICP status at 3 months. In a surgical population where decisions are based on disease progression, most of the changed status went from HICP preoperatively to none at 3 months. Both social and biological risk factors predicted HICP transition assignment.
dc.identifier

2021.11.SPINE211260

dc.identifier.issn

1547-5654

dc.identifier.issn

1547-5646

dc.identifier.uri

https://hdl.handle.net/10161/28048

dc.language

eng

dc.publisher

Journal of Neurosurgery Publishing Group (JNSPG)

dc.relation.ispartof

Journal of neurosurgery. Spine

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10.3171/2021.11.spine211260

dc.subject

cervical

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high-impact chronic pain

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myelopathy

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neck pain

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surgery

dc.title

High-impact chronic pain transition in surgical recipients with cervical spondylotic myelopathy.

dc.type

Journal article

duke.contributor.orcid

Cook, Chad E|0000-0001-8622-8361|0000-0002-5045-3281

duke.contributor.orcid

George, Steven Z|0000-0003-4988-9421

duke.contributor.orcid

Shaffrey, Christopher I|0000-0001-9760-8386

pubs.begin-page

1

pubs.end-page

10

pubs.issue

1

pubs.organisational-group

Duke

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School of Medicine

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Basic Science Departments

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Clinical Science Departments

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Institutes and Centers

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Orthopaedic Surgery

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Duke Clinical Research Institute

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Orthopaedic Surgery, Physical Therapy

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Neurosurgery

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Population Health Sciences

pubs.publication-status

Published

pubs.volume

37

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