Profiles of and correlation between objective and subjective outcome assessments following open-door laminoplasty for cervical spondylotic myelopathy.
- Author:
Feifei ZHOU
1
;
Yilong ZHANG
1
;
Yu SUN
2
;
Fengshan ZHANG
1
;
Shengfa PAN
1
;
Yinze DIAO
1
;
Xin CHEN
1
;
Yanbin ZHAO
1
Author Information
- Publication Type:Journal Article
- MeSH: Female; Humans; Laminoplasty; standards; Male; Middle Aged; Retrospective Studies; Spinal Cord Diseases; surgery
- From: Chinese Medical Journal 2014;127(14):2659-2663
- CountryChina
- Language:English
-
Abstract:
BACKGROUNDOpen-door laminoplasty is widely used in the treatment of cervical spondylotic myelopathy (CSM). This study aimed to investigate the profiles of and correlation between objective and subjective short-term outcome assessments after open-door laminoplasty for CSM.
METHODSWe retrospectively analyzed surgical outcomes in 129 consecutive CSM patients who underwent open-door laminoplasty in Peking University Third Hospital from February 2008 to November 2011. Both objective and subjective assessments were evaluated before surgery, 3 months after surgery, and 1 year after surgery. We then analyzed the profiles of and correlation between objective and subjective short-term outcomes.
RESULTSThe Modified Japanese Orthopaedic Association (mJOA) score was significantly improved at 3 months (P < 0.01) and 1 year (P < 0.01) after surgery. Bivariate Logistic regression showed that sensory improvement contributed more to the recovery rate than motor function improvement at 3 months after surgery, while motor function contributed more to the recovery rate at 1 year after surgery. On the subjective assessment (the short form (SF)-36 ), there was no significant improvement at 3 months after surgery (P > 0.05), while physical function (PF), role-physical (RP), and social function (SF) were notably improved at 1 year after surgery (P < 0.01). Improved mJOA score correlated with improvements in PF, RP, bodily pain, general health (GH), vitality (VT), and SF (P < 0.05) at 3 months after surgery; PF, GH, VT, and SF were associated with improved mJOA scores at 1 year after surgery.
CONCLUSIONSPatients benefit from surgery by postoperative restitution of neurological function with early recovery of sensory function, followed by a gradual transition to motor function improvement. At the early stage of recovery, improvement in the mJOA score essentially correlated with improvements in the physical domains of the SF-36, while at the later stage, mJOA score improvement was associated with improvements in both mental and physical domains of the SF-36.
