Ogura Yoji, Kobayashi Yoshiomi, Kitagawa Takahiro, Yonezawa Yoshiro, Takahashi Yoshiyuki, Yoshida Kodai, Yasuda Akimasa, Shinozaki Yoshio, Ogawa Jun
Department of Orthopaedic Surgery, Japanese Red Cross Shizuoka Hospital, Shizuoka, Shizuoka, Japan.
Department of Orthopaedic Surgery, Japanese Red Cross Shizuoka Hospital, Shizuoka, Shizuoka, Japan.
Clin Neurol Neurosurg. 2020 Apr;191:105710. doi: 10.1016/j.clineuro.2020.105710. Epub 2020 Feb 3.
Decompression surgery is the standard treatment for lumbar spinal stenosis (LSS); however, despite the good clinical outcomes reported for this procedure, a relatively high dissatisfaction rate has been reported. We hypothesized that the previously used outcome measures do not accurately reflect patient satisfaction (PS). This study aimed to examine which outcome measures reflect PS accurately in patients undergoing decompression for LSS.
Patients with LSS treated with lumbar decompression surgery between January 2014 and March 2016 were enrolled if they had the preoperative and final follow-up questionnaires including the Numeric Rating Scale (NRS), Roland-Morris Disability Questionnaire (RMDQ), Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), and Short Form-8 (SF-8). PS was evaluated using the question, "How satisfied are you with the overall result of your back operation?". There are four possible answers consisting of "very satisfied (4-point)", "somewhat satisfied (3-point)", "somewhat dissatisfied (2-point)", or "very dissatisfied (1-point)". The Spearman correlation coefficient between PS and each questionnaire was calculated.
Postoperative JOABPEQ had strong correlation with PS (r > 0.6) whereas NRS, RMDQ and SF-8 had moderate correlation (0.4 <r < 0.6). JOABPEQ reflected PS much better than other questionnaires.
JOABPEQ reflected PS and therefore may be used as a main outcome measure in evaluating patients who underwent decompression surgery for LSS.
减压手术是腰椎管狭窄症（LSS）的标准治疗方法；然而，尽管该手术报告了良好的临床结果，但仍有相对较高的不满意率。我们推测，以前使用的结果指标不能准确反映患者满意度（PS）。本研究旨在探讨哪些结果指标能准确反映接受LSS减压手术患者的PS。
纳入2014年1月至2016年3月接受腰椎减压手术治疗的LSS患者，条件是他们有术前和最终随访问卷，包括数字评定量表（NRS）、罗兰-莫里斯残疾问卷（RMDQ）、日本骨科协会背痛评估问卷（JOABPEQ）和简短健康调查问卷-8（SF-8）。使用“您对背部手术的总体结果有多满意？”这一问题评估PS。有四个可能的答案，分别为“非常满意（4分）”、“有些满意（3分）”、“有些不满意（2分）”或“非常不满意（1分）”。计算PS与每份问卷之间的Spearman相关系数。
术后JOABPEQ与PS有强相关性（r>0.6），而NRS、RMDQ和SF-8有中度相关性（0.4<r<0.6）。JOABPEQ比其他问卷更好地反映了PS。
JOABPEQ反映了PS，因此可作为评估接受LSS减压手术患者的主要结果指标。
