Degenerative cervical radiculopathy (DCR) is the most frequent indication for cervical spine surgery. Many patients presenting with arm pain and neck pain, also complain of headache (HA). This study investigates whether preoperative HA is an independent predictor of a non-successful surgical outcome. A cohort of 6,234 patients undergoing anterior cervical surgery for DCR were operated, prospectively registered in the Norwegian Registry for Spine Surgery (NORspine) and followed for one year. Baseline headache severity measured by numeric rating scale (NRS-HA) was used as exposure in multivariable mixed logistic regression models to determine its association with surgical non-success, defined as <35% improvement in the Neck Disability Index (NDI) at 12 months, while adjusting for possible confounders. A total of 4689 (75%) reported DCR-concomitant headaches at baseline, and the loss to follow-up at 12 month was 30%. Each 1-unit increase on the NRS-HA scale was significantly associated with a higher likelihood of surgical non-success, as shown by both the multivariable regression model (8% increase per unit, odds ratio (OR: 1.08, 95% confidence interval (CI): 1.05-1.11, p<0.001) and the mixed logistic model (21% increase per unit, OR: 1.21, 95% CI: 1.14-1.27, p<0.001). Higher preoperative headache severity was an independent prognostic factor for non-successful outcomes following DCR surgery. This information can be used in preoperative counselling, aimed at improving patient selection and prognosis. • Headache was common, with 75% of patients reporting degenerative cervical radiculopathy-concomitant headache (DCR-HA) preoperatively. • Higher preoperative headache severity independently predicted surgical non-success at 12 months. • For each 1-point increase in NRS-HA, the odds of non-success increased by 8% in the multivariable model (population level) and 21% in the mixed logistic model (individual level). • Preoperative headache severity may be useful in patient counselling
Habiba et al. (Fri,) studied this question.