Gerdhem Lovisa, MacDowall Anna, Gerdhem Paul
Torsby Hospital, Torsby; Department of Neurosurgery, Uppsala University Hospital, Uppsala, Sweden.
Department of Orthopaedics and Hand Surgery, Uppsala University Hospital, Uppsala; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Acta Orthop. 2025 Jan 9;96:26-32. doi: 10.2340/17453674.2024.42630.
Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord dysfunction in adults. Repeated follow-ups after surgery are resource consuming. The aim was to examine whether patient-reported outcome measures (PROMs) change after the first year. The purpose of this study was to investigate whether it is necessary to obtain follow-up data from patients more than 1 year after surgery for DCM.
We included individuals treated surgically for DCM in the Swedish Spine registry (Swespine), with available preoperative, 1-, and 2-year PROMs, primarily the European Myelopathy Scale (EMS) and secondarily the Neck Disability Index (NDI), and the European Quality of life Visual Analogue Scale (EQ-VAS). A tertiary analysis included available 5-year data. Median, interquartile range (IQR), and Bland-Altman plots were used to compare PROM data at different follow-up time points.
642 individuals had baseline, 1-, and 2-year follow-up data, of whom 347 also had 5-year data. EMS was 14 (12-16) preoperative, 15 (12-17) at the 1-year follow-up, and 15 (12-17) at the 2-year follow-up. Corresponding data for NDI was 38 (24-50), 25 (12-42), and 26 (12-42) and for EQ-VAS 50 (30-60), 60 (42-77), and 60 (40-75). Similar findings were seen in individuals who also had 5-year data. Bland-Altman plots indicated good agreement between 1- and 2-year data, and between 1- and 5-year data and were without proportional bias.
In individuals treated for DCM no clinically meaningful change in PROMs occurred after the 1-year follow-up.
退行性颈椎脊髓病（DCM）是成人脊髓功能障碍最常见的原因。术后反复随访耗费资源。本研究旨在检验患者报告结局指标（PROMs）在术后第一年之后是否会发生变化。本研究的目的是调查对于DCM患者，术后1年以上是否有必要获取其随访数据。
我们纳入了瑞典脊柱登记系统（Swespine）中接受DCM手术治疗的个体，这些个体有术前、1年和2年的PROMs数据，主要是欧洲脊髓病量表（EMS），其次是颈部功能障碍指数（NDI）和欧洲生活质量视觉模拟量表（EQ-VAS）。一项三级分析纳入了可用的5年数据。采用中位数、四分位间距（IQR）和布兰德-奥特曼图来比较不同随访时间点的PROMs数据。
642名个体有基线、1年和2年的随访数据，其中347名个体也有5年数据。术前EMS为14（12 - 16），1年随访时为15（12 - 17），2年随访时为15（12 - 17）。NDI的相应数据分别为38（24 - 50）、25（12 - 42）和26（12 - 42），EQ-VAS的相应数据分别为50（30 - 60）、60（42 - 77）和60（40 - 75）。在有5年数据的个体中也观察到了类似的结果。布兰德-奥特曼图表明1年和2年数据之间、1年和5年数据之间一致性良好，且无比例偏差。
在接受DCM治疗的个体中，术后1年随访后PROMs未出现具有临床意义的变化。
