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.

• Authors: Narihito Nagoshi, Osahiko Tsuji, Eijiro Okada, Nobuyuki Fujita, Mitsuru Yagi, Takashi Tsuji, Masaya Nakamura, Morio Matsumoto, Kota Watanabe
• Journal: Spinal cord (Spinal Cord) Vol. 57 Issue 8 Pg. 644-651 (Aug 2019) ISSN: 1476-5624 [Electronic] England
• PMID: 30792540 (Publication Type: Journal Article)

Topics

• Aged
• Cervical Vertebrae (diagnostic imaging, surgery)
• Cohort Studies
• Female
• Follow-Up Studies
• Humans
• Japan (epidemiology)
• Laminoplasty (trends)
• Male
• Middle Aged
• Recovery of Function (physiology)
• Retrospective Studies
• Spinal Cord Diseases (diagnostic imaging, epidemiology, surgery)
• Surveys and Questionnaires (standards)
• Treatment Outcome