1Department of Neurological Surgery, University of California, San Francisco, California.
2Department of Neurosurgery, Columbia University, New York, New York.
Neurosurg Focus. 2023 Nov;55(5):E7. doi: 10.3171/2023.8.FOCUS23423.
There is a high prevalence of cervical myelopathy that requires surgery; as such, it is important to identify how different groups benefit from surgery. The American Association of Neurological Surgeons launched the Quality Outcomes Database (QOD), a prospective longitudinal registry, that includes demographic, clinical, and patient-reported outcome data to measure the safety and quality of neurosurgical procedures. In this study, the authors assessed the impact of gender on patient-reported outcomes in patients who underwent surgery for cervical myelopathy.
The authors analyzed 1152 patients who underwent surgery for cervical myelopathy and were included in the QOD cervical module. Univariate comparison of baseline patient characteristics between males and females who underwent surgery for cervical spondylotic myelopathy was performed. Baseline characteristics that significantly differed between males and females were included in a multivariate generalized linear model comparing baseline and 1-year postoperative Neck Disability Index (NDI) scores.
This study included 546 females and 604 males. Females demonstrated significantly greater improvement in NDI score 1 year after surgery (p = 0.036). In addition to gender, the presence of axial neck pain and insurance status were also significantly predictive of improvement in NDI score after surgery (p = 0.0013 and p = 0.0058, respectively).
Females were more likely to benefit from surgery for cervical myelopathy compared with males. It is important to identify gender differences in postoperative outcomes after surgery in order to deliver more personalized and patient-centric care.
患有脊髓型颈椎病且需要手术的患者人数较多；因此，明确不同患者群体从手术中获益的情况非常重要。美国神经外科学会（American Association of Neurological Surgeons）推出了质量结果数据库（Quality Outcomes Database，QOD），这是一个前瞻性纵向登记处，其中包含人口统计学、临床和患者报告的结果数据，用于衡量神经外科手术的安全性和质量。在这项研究中，作者评估了性别对接受脊髓型颈椎病手术治疗的患者报告结果的影响。
作者分析了在 QOD 颈椎模块中接受脊髓型颈椎病手术的 1152 例患者。对接受手术治疗的男性和女性患者的基线特征进行了单变量比较。将在男性和女性之间存在显著差异的基线特征纳入多元广义线性模型，比较基线和 1 年术后颈部残疾指数（Neck Disability Index，NDI）评分。
本研究纳入了 546 名女性和 604 名男性患者。女性在手术后 1 年的 NDI 评分显著提高（p = 0.036）。除了性别外，轴向颈部疼痛的存在和保险状况也是术后 NDI 评分改善的显著预测因素（p = 0.0013 和 p = 0.0058）。
与男性相比，女性更有可能从脊髓型颈椎病手术中获益。为了提供更个性化和以患者为中心的护理，识别术后结局的性别差异非常重要。
