The type of cervical disc herniation on MRI does not correlate to clinical outcomes

• Published in: Journal of bone and joint surgery. British volume Vol. 104-B; no. 11; pp. 1242 - 1248
• Main Authors: Yang, Xiaoyu, Arts, Mark P, Ronald H M A Bartels, Vleggeert-Lankamp, Carmen L A
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone & Joint Surgery 01-11-2022
• Subjects: Clinical outcomes
• ISSN: 2049-4394; 2049-4408
• DOI: 10.1302/0301-620X.104B11.BJJ-2022-0657.R2

AimsThe aim of this study was to investigate whether the type of cervical disc herniation influences the severity of symptoms at the time of presentation, and the outcome after surgical treatment.MethodsThe type and extent of disc herniation at the time of presentation in 108 patients who underwent anterior discectomy for cervical radiculopathy were analyzed on MRI, using a four-point scale. These were dichotomized into disc bulge and disc herniation groups. Clinical outcomes were evaluated using the Neck Disability Index (NDI), 36-Item Short Form Survey (SF-36), and a visual analogue scale (VAS) for pain in the neck and arm at baseline and two years postoperatively. The perceived recovery was also assessed at this time.ResultsAt baseline, 46 patients had a disc bulge and 62 had a herniation. There was no significant difference in the mean NDI and SF-36 between the two groups at baseline. Those in the disc bulge group had a mean NDI of 44.6 (SD 15.2) compared with 43.8 (SD 16.0) in the herniation group (p = 0.799), and a mean SF-36 of 59.2 (SD 6.9) compared with 59.4 (SD 7.7) (p = 0.895). Likewise, there was no significant difference in the incidence of disabling arm pain in the disc bulge and herniation groups (84% vs 73%; p = 0.163), and no significant difference in the incidence of disabling neck pain in the two groups (70.5% (n = 31) vs 63% (n = 39); p = 0.491). At two years after surgery, no significant difference was found in any of the clinical parameters between the two groups.ConclusionIn patients with cervical radiculopathy, the type and extent of disc herniation measured on MRI prior to surgery correlated neither to the severity of the symptoms at presentation, nor to clinical outcomes at two years postoperatively.Cite this article: Bone Joint J 2022;104-B(11):1242–1248.