Factors Affecting the Outcome of Surgical Versus Nonsurgical Treatment of XXXX : A Randomized, Controlled Study.

@entity1 @entity614 @entity11375 @entity147 @entity148 @entity4048 @entity158 @entity3040
STUDY DESIGN: Prospective randomized controlled trial. OBJECTIVE: To analyze factors that may influence the outcome of @entity11375 ( @entity11375 ) followed by physiotherapy versus physiotherapy alone for treatment of @entity1 with @entity614 . SUMMARY OF BACKGROUND DATA: An understanding of @entity1 -related factors affecting the outcome of @entity11375 is important for preoperative @entity1 selection. No previous prospective, randomized study of treatment effect modifiers relating to outcome of @entity11375 compared with physiotherapy has been carried out. METHODS: 60 @entity1 with @entity614 were randomized to @entity11375 followed by physiotherapy or physiotherapy alone. Data for possible modifiers of treatment outcome at 1 year, such as sex, age, duration of @entity158 , @entity158 intensity, disability (Neck Disability Index, @entity3040 ), @entity1 expectations of treatment, @entity148 due to neck/ @entity158 , distress ( @entity147 and Risk Assessment Method), self-efficacy (Self-Efficacy Scale) health status (EQ-5D), and magnetic resonance imaging findings were collected. A multivariate analysis was performed to find treatment effect modifiers affecting the outcome regarding arm/ @entity4048 intensity and @entity3040 . RESULTS: Factors that significantly altered the treatment effect between treatment groups in favor of surgery were: duration of @entity4048 less than 12 months (P = 0.007), duration of @entity158 less than 12 months (P = 0.01) and female sex (P = 0.007) (outcome: @entity158 ), low EQ-5D index (outcome: @entity4048 , P = 0.02), high levels of @entity148 due to neck/ @entity158 (outcome: @entity4048 , P = 0.02 and @entity3040 , P = 0.02), low Self-Efficacy Scale score (P = 0.05), and high @entity147 and Risk Assessment Method score (P = 0.04) (outcome: @entity3040 ). No factors were found to be associated with better outcome with physiotherapy alone. CONCLUSION: In this prospective, randomized study of @entity1 with @entity614 , short duration of @entity158 , female sex, low health quality, high levels of @entity148 due to neck/ @entity158 , low self-efficacy, and a high level of distress before treatment were associated with better outcome from surgery. No factors were found to be associated with better outcome from physiotherapy alone. LEVEL OF EVIDENCE: 2.
