• Eur Spine J · Oct 2022

    Randomized Controlled Trial

    What is success of treatment? Expected outcome scores in cervical radiculopathy patients were much higher than the previously reported cut-off values for success.

    • Mirad Taso, Jon Håvard Sommernes, Siri Bjorland, John Anker Zwart, Kaia Beck Engebretsen, Jarle Sundseth, Are Hugo Pripp, Frode Kolstad, and Jens Ivar Brox.
    • Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ullevål, Postboks 4956, Nydalen, 0424, Oslo, Norway. mirtas@ous-hf.no.
    • Eur Spine J. 2022 Oct 1; 31 (10): 276127682761-2768.

    PurposeTreatment success can be defined by asking a patient how they perceive their condition compared to prior to treatment, but it can also be defined by establishing success criteria in advance. We evaluated treatment outcome expectations in patients undergoing surgery or non-operative treatment for cervical radiculopathy.MethodsThe first 100 consecutive patients from an ongoing randomized controlled trial (NCT03674619) comparing the effectiveness of surgical and nonsurgical treatment for cervical radiculopathy were included. Patient-reported outcome measures and expected outcome and improvement were obtained before treatment. We compared these with previously published cut-off values for success. Arm pain, neck pain and headache were measured by a numeric rating scale. Neck disability index (NDI) was used to record pain-related disability. We applied Wilcoxon signed-rank test to compare the expected outcome scores for the two treatments.ResultsPatients reported mean NDI of 42.2 (95% CI 39.6-44.7) at baseline. The expected mean NDI one year after the treatment was 4 (95% CI 3.0-5.1). The expected mean reduction in NDI was 38.3 (95% CI 35.8-40.8). Calculated as a percentage change score, the patients expected a mean reduction of 91.2% (95% CI 89.2-93.2). Patient expectations were higher regarding surgical treatment for arm pain, neck pain and working ability, P < 0.001, but not for headache.ConclusionsThe expected improvement after treatment of cervical radiculopathy was much higher than the previously reported cut-off values for success. Patients with cervical radiculopathy had higher expectations to surgical treatment.© 2022. The Author(s).

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