Neurospine.  2026 Jul;23(3):593-604. 10.14245/ns.26520658.0329.

Explanatory Factors for Neck-Related Disability, Headache, and Pain After Cervical Decompression Surgery in Individuals With Cervical Radiculopathy and Neck-Related Headache: A National Registry-Based Study With 2-Year Follow-up

• Svensson J
• Löfgren H
• Hermansen A
• Zsigmond P
• Peolsson A

• KMID: 2583369
• DOI: http://doi.org/10.14245/ns.26520658.0329

Abstract

Objective
To investigate explanatory factors associated with neck-related disability, headache, and neck and arm pain 2 years after anterior cervical decompression and fusion (ACDF) or posterior cervical foraminotomy (PCF) in individuals with cervical radiculopathy (CR) and neck-related headache.
Methods
This registry-based cohort study used prospectively collected data with a 2-year follow-up from the Swedish Spine Registry. Individuals who underwent ACDF (n=1,866) or PCF (n=357) for CR between January 2016 and March 2021 and reported preoperative neck-related headache were included. Standard analysis of covariance models were used to identify explanatory factors for the absolute values of Neck Disability Index (NDI), NDI-headache, Numerical Rating Scale (NRS) neck pain, and NRS arm pain at the 2-year follow-up after ACDF or PCF.
Results
Explanatory factors explained 33% and 32% of the neck-related disability, 20% and 35% of the headache, 21% and 13% of the neck pain, and 16% and 24% of the arm pain at 2-year follow-up after ACDF and PCF, respectively, in individuals with CR and neck-related headache. The preoperative value of these outcomes had the greatest impact, except for neck and arm pain after PCF, where neck-related disability had a greater impact.
Conclusion
Neck-related disability, headache, and neck and arm pain after ACDF and PCF in individuals with CR and neck-related headache are associated with preoperative levels of these outcomes, as well as demographic, lifestyle, surgical factors and self-reported health, that should be considered before surgery. The models explained 13%–35% of the variance in the outcomes, indicating that a substantial proportion remains unexplained.

Keyword

Cervical radiculopathy; Disability evaluation; Headache; Pain; Decompression