The Confounding Burden of Psychological Impairments in Cervical Spine Surgery

Inclusion criteria

Patients at Risk:

• Diagnosed of primary symptomatic cervical degenerative disc disease confirmed with appropriate imaging studies.
• Etiologies will be limited to cervical disc herniation, spinal stenosis, low-grade (I and II) spondylolisthesis, spondylosis and degenerative disc disease.
• Will be undergoing elective cervical spine surgery, not to exceed 5 levels.
• Presence of both axial (neck pain) and appendicular (arm pain/dysesthesia/weakness) symptoms, regardless of proportion
• Subject must be able to be contacted by telephone during study participation
• NDI > 20%
• Read and comprehend English

Inclusion criteria

for patients with zero risk:

• Diagnosed of primary symptomatic cervical degenerative disc disease confirmed with appropriate imaging studies.
• Etiologies will be limited to cervical disc herniation, spinal stenosis, low-grade (I and II) spondylolisthesis, spondylosis and degenerative disc disease.
• Will be undergoing elective cervical spine surgery, not to exceed 5 levels.
• Presence of both axial (neck pain) and appendicular (arm pain/dysesthesia/weakness) symptoms, regardless of proportion
• Subject must be able to be contacted by telephone during study participation
• NDI > 20%
• Read and comprehend English

Exclusion criteria

Exclusion criteria

for patients at risk:

• Contraindicated to surgical treatment of the cervical spine.
• Prior cervical fusion
• Evidence of severe cervical spinal deformity based on Ames classification: C2-C7 SVA > 8cm, Horizontal Gaze < -10 or > 25, T1S-CL > 20, myelopathy (JOA score <10) or severe adult spinal deformity based on SRS-Schwab classification (PI-LL > 20, PT >30, SVA > 90 mm)
• Undergoing simultaneous treatment for thoracolumbar spine related diagnoses at the time of enrollment History of any spinal surgery within the last 6 months
• Patients with neck pain attributable to trauma, idiopathic deformity, neoplasm, osteoporosis, or other medical condition.
• Unlikely to comply with the follow-up evaluation schedule
• Subject has recent history of chemical substance dependency that may impact the outcome or study participation

Exclusion criteria

for patients with zero risk:

• Contraindicated to surgical treatment of the cervical spine.
• Prior cervical fusion
• Evidence of severe cervical spinal deformity based on Ames classification: C2-C7 SVA > 8cm, Horizontal Gaze < -10 or > 25, T1S-CL > 20, myelopathy (JOA score <10) or severe adult spinal deformity based on SRS-Schwab classification (PI-LL > 20, PT >30, SVA > 90 mm)
• Undergoing simultaneous treatment for thoracolumbar spine related diagnoses at the time of enrollment History of any spinal surgery within the last 6 months
• Patients with neck pain attributable to trauma, idiopathic deformity, neoplasm, osteoporosis, or other medical condition.
• Unlikely to comply with the follow-up evaluation schedule
• Subject has recent history of chemical substance dependency that may impact the outcome or study participation
• Subject has a significant psychosocial disturbance or psychiatric history that may impact the outcome or study participation including a DRAM score over 33
• Active infection
• Systemic infection (AIDS, HIV, or active hepatitis)
• Active litigation
• Presence of inflammatory spinal disease (e.g. chronic autoimmune conditions, ankylosing spondylitis, DISH, Rheumatoid Arthritis)
• Concurrent Spinal or pelvic fracture