Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 6.
doi: 10.1097/BSD.0000000000001824. Online ahead of print.

Failure to Reach Early MCID in ACDF Patients

Andrea M Roca  1 , Fatima N Anwar, Ishan Khosla, Srinath S Medakkar, Alexandra C Loya, Arash J Sayari, Gregory D Lopez, Kern Singh
Affiliations

Failure to Reach Early MCID in ACDF Patients

Andrea M Roca et al. Clin Spine Surg. .

Abstract

Study design: Retrospective cohort study.

Objective: The objective of this study is to identify factors of early minimal clinically important difference (MCID) failure after anterior cervical discectomy and fusion (ACDF).

Summary of background data: Research on predictors of MCID failure after ACDF is limited.

Methods: Patients undergoing primary, elective ACDF were selected from a single spine surgeon database. Demographics, perioperative characteristics, and Visual Analog Scale Neck (VAS-N), VAS-Arm (VAS-A), Neck Disability Index (NDI), patient-reported outcome measurement information system-physical function (PROMIS-PF), 12-item Short Form (SF-12) Mental Component Score (MCS), SF-12 Physical Component Score (SF-12 PCS), and 9-item Patient Health Questionnaire (PHQ-9) scores were collected. A 2-step multivariable logistic regression was performed to determine predictors of MCID failure.

Results: A total of 240 patients were included. Preoperative VAS-N and diagnosis of foraminal stenosis were significant positive predictors of failure. Workers' compensation (WC) was a negative predictor, whereas smoker status and preoperative VAS-A were positive predictors. Preoperative PROMIS-PF, preoperative SF-12 PCS/MCS, and postoperative day 0 narcotic consumption were negative predictors, and length of stay was a positive predictor.

Conclusion: The variations in follow-up compliance among spine surgery patients highlight the importance of identifying predictors of early MCID failure rates to avoid less than favorable patient experiences. In our study, we identified data to suggest that positive predictors of early failure may be associated with higher preoperative neck pain, smoker status, and longer length of stay. In comparison, negative predictors are related to WC insurance, better preoperative physical function and mental health, or postoperative narcotic consumption.

Keywords: anterior cervical discectomy and fusion; cervical spine; minimal clinically important difference; outcomes.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Borghouts JAJ, Koes BW, Bouter LM. The clinical course and prognostic factors of non-specific neck pain: a systematic review. Pain. 1998;77:1–13.
    1. Riew KD, Ecker E, Dettori JR. Anterior cervical discectomy and fusion for the management of axial neck pain in the absence of radiculopathy or myelopathy. Evid Based Spine Care J. 2010;1:45–50.
    1. Van Der Wees PJ, Nijhuis-Van Der Sanden MWG, Ayanian JZ, et al. Integrating the use of patient-reported outcomes for both clinical practice and performance measurement: views of experts from 3 countries. Milbank Q. 2014;92:754–775.
    1. Tetreault L, Kopjar B, Côté P, et al. A clinical prediction rule for functional outcomes in patients undergoing surgery for degenerative cervical myelopathy: analysis of an international prospective multicenter data set of 757 subjects. J Bone Joint Surg Am. 2015;97:2038–2046.
    1. Hamilton T, Lim S, Telemi E, et al. Risk factors for not reaching minimal clinically important difference at 90 days and 1 year after elective lumbar spine surgery: a cohort study. J Neurosurg Spine. 2024;40:343–350.

LinkOut - more resources