Association Between Preoperative SF-36 and Postoperative Axial Neck Pain in Patients With Cervical Spondylotic Myelopathy After Anterior Decompressive Surgery

STUDY DESIGN: A single-center retrospective study. OBJECTIVE: This study investigates the correlation between preoperative SF-36 scores and postoperative axial neck pain (ANP) in cervical spondylotic myelopathy (CSM) patients undergoing anterior cervical surgery (ACS). SUMMARY OF BACKGROUND DATA: The effects of the anterior surgical approach on ANP are not well understood. METHODS: This retrospective study included patients with CSM at Peking University Third Hospital between April 2010 and March 2016. The SF-36, visual analog scale (VAS), and Neck Disability Index (NDI) were collected preoperatively and postoperatively at 3 months, 1 year, and 2 years. RESULTS: In 107 CSM patients, ACS significantly improved pain, physical function, and quality of life over 2 years. VAS scores decreased from 6.4±2.3 to 3.8±1.9, indicating less ANP (P=0.013). SF-36 scores improved notably in social functioning and bodily pain domains. NDI scores also decreased, showing reduced neck disability (P=0.012). Patients with ANP post-ACS had consistently lower preoperative bodily pain and social functioning scores at follow-up of 3 timepoints. Correlation analysis revealed a significant negative relationship between VAS and preoperative bodily pain and social functioning scores (P<0.05), suggesting that lower preoperative scores may predict severe postoperative ANP. CONCLUSIONS: Anterior cervical surgery does not increase the incidence of postoperative ANP in patients with CSM. The BP and SF domains of the preoperative SF-36 are correlated with the occurrence of postoperative ANP.