Background & Aims

Individuals with cervical radiculopathy presents with radiating pain to one or both arms, motor and/or sensory disturbances to the affected arm, and neck pain. In addition, many individuals experience headache and dizziness. These symptoms cause disability and reduced quality of life. A common surgical method aimed to reduce neurological symptoms and pain is anterior decompression and fusion surgery, about 80% report improvements1. Men report less pain and disability both before and after surgery than women2. It is important to identify potential gender specific thoughts, feelings, and behaviors to provide patient centered and adequate care and rehabilitation to patients after neck surgery. There are no previous qualitative studies on daily life after anterior cervical decompression surgery except one investigation focusing on women3. Thus, the aim of this study was to explore and describe men’s experiences of their daily life after anterior cervical decompression and fusion surgery.

Methods

This is a qualitative explorative study using individual semi-structured interviews for data collection and analyzed with qualitative content analysis4. A purposeful sample of 14 men aged 34 – 70 years were recruited from the neurosurgical/neuro-orthopedic clinics at two hospitals in the southeastern part of Sweden. All participants had been treated with anterior cervical decompression and fusion due to cervical degenerative disc disease within the past 18-36 months.
The interview guide was based on the previous study focusing on women. In the data analysis a deductive-inductive approach was applied. In the deductive part of the analysis, codes were tentatively sorted into pre-existing sub-categories or categories from the study on women. Codes that did not fit into any pre-existing sub- categories or categories were inductively sorted into new categories. Analyst triangulation was applied to increase trustworthiness.

Results

Six categories were found: Being recovered or not, Description of remaining symptoms, Thoughts/feelings regarding outcome and daily life. Making daily life work, Receiving support from social and occupational networks, and Experiences of interventions and encounters with healthcare professionals. Experiences of daily life varied from restored to worse and being functional despite remaining problems and being a different person depending on symptoms. Symptoms were also described in relation to activities or movements in daily life and how symptoms (or lack of symptoms) affected thoughts/feelings. To make daily life functional, both active and passive strategies and cognitive ways of coping with daily life were described. The importance of being able to work was expressed, and the conditions for being able to work again ranged from small adjustments to changing jobs. Improvements in symptoms after surgery was credited the surgeons, however some men had negative experiences of healthcare.

Conclusions

Daily life was experienced as varying from being restored to worse. Remaining symptoms were described mostly related to activities. A wide range of active and passive strategies, including cognitive strategies, were performed in an effort to cope with these symptoms. In contrast to women’s descriptions of their experiences, the men were more detailed in describing their symptoms and discussed these more in relation to specific activities or movements than women. The men described learning coping strategies from experience while women focused more on coping with symptoms in general. The importance of going to work was emphasized by the men in the present study. The results indicates that men experience symptoms and activity limitations, and they strive to find strategies to cope with these in their daily lives like women but expressed somewhat differently.

References

1 Blom C, Parai C, Thoreson O. Hägg O. The Swedish spine registry. Annual Report 2023 – Follow-Up of Spine Surgery in Sweden 1998 – 2022.
2 Hermansen A, Hedlund R, Vavruch L, Peolsson A. Positive predictive factors and sub-group analysis of clinically relevant improvement after anterior cervical decompression and fusion for cervical disc disease: a 10 – to 13-year follow-up och a prospective randomized study. J Neurosurg: Spine. 2013;19:403-411.
3 Hermansen A, Peolsson A, Kammerlind A-S, Hjelm K. Women’s experiences of daily life after anterior cervical decompression and fusion surgery: A qualitative interview study. J Rehabil Med. 2016;48: 352-358.
4 Patton MQ. Qualitative research & evaluation methods. London: SAGE; 2015.

Presenting Author

Anna Hermansen

Poster Authors

Anna Hermansen

PhD

Linköping University

Lead Author

E-mail

Anneli Peolsson

PhD

Linköping University Faculty of Health sciences

Lead Author

E-mail

Håkan Löfgren Associate Professor

PhD.

Ryhov Hospital, Region Jönköping County and Linköping University

Lead Author

E-mail

Katarina Hjelm PhD.

MScN

Dpt of Public Health and Caring Sciences, Uppsala University

Lead Author

E-mail

Topics

  • Specific Pain Conditions/Pain in Specific Populations: Neck Pain