• Kevin Hines, Joseph Schaefer, Eric Tecce, Glenn A Gonzalez, Karim Hafazalla, Daniel Franco, Adam Leibold, Thiago S Montenegro, Srinivas Prasad, Jack Jallo, Joshua Heller, Ashwini Sharan, and James Harrop.
• Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA. Electronic address: kevin.hines@jefferson.edu.
• World Neurosurg. 2022 May 1; 161: e395-e400.

BackgroundPatients with a history of surgically treated cervical myelopathy and lumbar pathology requiring fusion present complex challenges, and literature describing patient-reported outcomes in this cohort beyond patients with tandem spinal stenosis is sparse. This has led to unclear guidelines in the literature. We present the first dataset comparing patient-reported outcomes for lumbar fusion in patients with isolated lumbar pathology versus patients with a history of surgically treated cervical myelopathy.MethodsIn this retrospective cohort study of a prospectively collected lumbar fusion database, variables of interest included demographics, comorbidities, type and levels of fusion, Oswestry Disability Index (ODI), and minimal clinically important difference.ResultsOf 325 patients identified, 309 met inclusion criteria. Of these, 29 patients had previous cervical surgery to address cervical myelopathy. Median time between cervical and lumbar surgery was 4.0 years (range, 0.3-19.7). There was no statistical difference in preoperative ODI score (24.8 vs. 25.6, P = 0.687), 6-month postoperative ODI score (17.3 vs. 18.7, P = 0.459), change in ODI score (7.5 vs. 6.9, P = 0.673), or minimal clinically important difference for ODI score (62.1% vs. 58.6%, P = 0.710) in patients who had undergone cervical surgery versus patients who had not.ConclusionsPatients with a history of previously treated cervical myelopathy have a similar rate of clinically relevant improvement after lumbar fusion compared with patients without such history. As such, these patients appear to benefit from lumbar fusion surgery to the same degree as patients without a history of surgically treated cervical myelopathy.Copyright © 2022 Elsevier Inc. All rights reserved.

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