Evolution of Patient-Reported Outcome Measures After Surgery for Degenerative Cervical Spine Disease: Do 1-year PROMs Reflect Longer Term Outcomes?

Victor Gabriel El-Hajj; Cecilia Kjaerbeck; Victor E Staartjes; Erik Edström; Adrian Elmi-Terander

doi:10.1227/neu.0000000000003886

Evolution of Patient-Reported Outcome Measures After Surgery for Degenerative Cervical Spine Disease: Do 1-year PROMs Reflect Longer Term Outcomes?

Neurosurgery. 2025 Dec 19. doi: 10.1227/neu.0000000000003886. Online ahead of print.

Authors

Victor Gabriel El-Hajj¹, Cecilia Kjaerbeck¹, Victor E Staartjes^{1

2

3}, Erik Edström^{1

3}, Adrian Elmi-Terander^{1

3

4}

Affiliations

¹ Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
² Machine Intelligence in Clinical Neuroscience and Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, University Hospital Zurich, Zürich, Switzerland.
³ Capio Spine Center Stockholm, Löwenströmska Hospital, Stockholm, Sweden.
⁴ Department of Medical Sciences, Örebro University, Örebro, Sweden.

PMID: 41416797
DOI: 10.1227/neu.0000000000003886

Abstract

Background and objectives: Patient-reported outcome measures (PROMs) are today's gold standard outcomes in surgery for degenerative cervical spine disorders. Long-term outcome research may be limited by missing data at later follow-up time-points. Previous studies on lumbar disorders suggest that no significant changes to PROMS occur after 1-year postsurgery. However, no previous study has examined the evolution of PROMS after surgery for degenerative cervical spine disease. We hence aimed to study the evolution of PROMs at 1, 2, and 5 years of postoperative follow-up in patients with cervical spondylosis treated for degenerative radiculopathy or myelopathy.

Methods: A total of 6467 patients (4785 radiculopathy and 1682 myelopathy) undergoing surgery for cervical spondylosis between 2006 and 2018 in Sweden were included. Prerequisites for inclusion were PROMs at 1 and 2 or 5 years. The evolution of PROMs over time, the correlation between 1-year PROMs and 2- or 5-year PROMs and the predictive capability of 1-year PROMs were assessed.

Results: No significant changes in PROMs beyond 1-year postoperatively could be observed among both degenerative radiculopathy and myelopathy cohorts (P ≥ .05). Significant (P < .0001) moderately strong to strong correlations were found between 1-year and 2- or 5-year PROMs (Pearson's R ranging from 0.56 to 0.85). On univariable analysis, 1-year PROMs were found to be strong predictors of long-term outcomes (P < .0001).

Conclusions: After surgery for cervical spondylosis with either degenerative radiculopathy or myelopathy, PROMs remained stable beyond 1 year, with minimal changes occurring thereafter. 1-year PROMs correlated with and served as a good proxy for predicting 2- and 5-year PROMs. This suggests that on a population level, 1-year PROMs are sufficient to assess longer term outcomes.

Keywords: Cervical spondylosis; PROMs; Patient-reported outcome measures; Spine surgery.