Tamai Koji, Suzuki Akinobu, Terai Hidetomi, Kato Minori, Toyoda Hiromitsu, Takahashi Shinji, Yabu Akito, Sawada Yuta, Iwamae Masayoshi, Nakamura Hiroaki
Department of Orthopedics, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan.
J Clin Med. 2022 Sep 4;11(17):5230. doi: 10.3390/jcm11175230.
The mid-term surgical outcomes of cervical spondylotic myelopathy (CSM), evaluated using the cervical Japanese Orthopedic Association (cJOA) score, are reported to be satisfactory. However, there remains room for improvement in quality-of-life (QOL), especially after short-term follow-up. We aimed to demonstrate changes in mental and physical QOL between short- and mid-term follow-ups and determine the predictive factors for deterioration of QOL. In this retrospective cohort study, 80 consecutive patients underwent laminoplasty for CSM. The outcome measures were Short Form-36 Physical Component Summary (PCS), Mental Component Summary (MCS), and cJOA scores. PCS and MCS scores were compared at the 2- and 5-year postoperative time points. Additionally, a multivariate logistic regression model was used to identify the predictive factors for deterioration. Significant factors in the logistic regression analysis were analyzed using receiver-operating characteristic curves. The results showed that MCS scores did not deteriorate after 2 years postoperatively (p = 0.912). Meanwhile, PCS significantly declined between 2 and 5 years postoperatively (p = 0.008). cJOA scores at 2 years postoperatively were significantly associated with PCS deterioration at 2-year follow-up. In conclusion, only physical QOL might show deterioration after short-term follow-up. Such deterioration is likely in patients with a cJOA score <13.0 at 2 years postoperatively.
据报道，采用日本骨科协会颈椎病（cJOA）评分评估的脊髓型颈椎病（CSM）中期手术效果令人满意。然而，生活质量（QOL）仍有改善空间，尤其是在短期随访之后。我们旨在证明短期和中期随访之间心理和身体QOL的变化，并确定QOL恶化的预测因素。在这项回顾性队列研究中，80例连续的CSM患者接受了椎板成形术。结局指标为简明健康状况调查量表身体成分总结（PCS）、心理成分总结（MCS）和cJOA评分。在术后2年和5年的时间点比较PCS和MCS评分。此外，使用多因素逻辑回归模型确定恶化的预测因素。使用受试者工作特征曲线分析逻辑回归分析中的显著因素。结果显示，术后2年MCS评分没有恶化（p = 0.912）。同时，术后2至5年PCS显著下降（p = 0.008）。术后2年的cJOA评分与2年随访时的PCS恶化显著相关。总之，短期随访后可能只有身体QOL会出现恶化。术后2年cJOA评分<13.0的患者可能会出现这种恶化。
