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Clinical indicators of surgical outcomes after cervical single open-door laminoplasty assessed by the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire.

Abstract：

STUDY DESIGN:Retrospective cohort study. OBJECTIVES:The old-version JOA score for cervical myelopathy (CM) is an evaluation system performed by medical providers that focuses only on neurological function. The purpose of this study was to evaluate patient-reported outcomes using the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), and to clarify clinical factors that affect the therapeutic effectiveness for CM. SETTING:Single institute in Japan. METHODS:We reviewed surgical outcomes for 126 CM patients who were treated by single open-door laminoplasty and were followed at least 2 years. We assessed clinical information, JOACMEQ, JOA scores, and radiographic parameters. Patients were grouped according to effective or ineffective surgical outcomes as defined by the JOACMEQ using logistic regression analyses. RESULTS:Laminoplasty resulted in functional improvement in the cervical spine and extremities for 40-50% of the patients, while bladder function showed only minimal recovery. Multivariable analyses revealed that a significant postoperative reduction in neck or shoulder pain influenced the effective functional recovery of the cervical spine. A reduction in arm or hand pain favorably affected the postoperative upper extremity function. Lower age and a postoperative decrease in limb pain were correlated with significantly improved function of the lower extremities. A postoperative reduction in arm pain enhanced the QOL recovery. CONCLUSIONS:The JOACMEQ makes it possible to analyze multiple aspects of surgical outcomes for patients who undergo cervical spine surgery. Open-door laminoplasty did not provide favorable results for some patients, which highlights the importance of assessing the indications for this procedure and managing postoperative pain.

journal_name

Spinal Cord

journal_title

Spinal cord

authors

Nagoshi N,Tsuji O,Okada E,Fujita N,Yagi M,Tsuji T,Nakamura M,Matsumoto M,Watanabe K

doi

10.1038/s41393-019-0258-4

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

644-651

issue

eissn

1362-4393

issn

1476-5624

pii

10.1038/s41393-019-0258-4

journal_volume

pub_type

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Clinical indicators of surgical outcomes after cervical single open-door laminoplasty assessed by the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire.