Temporal changes of hand dexterity in patients with cervical spondylotic myelopathy after decompression surgery
10.3969/j.issn.1004-406X.2024.11.02
- VernacularTitle:脊髓型颈椎病患者减压术后手灵活性变化的时间规律
- Author:
Tianying LIAO
1
;
Guoyan LIANG
1
;
Yongyu YE
1
Author Information
1. 广东省人民医院(广东省医学科学院)脊柱外科 510080 广州市
- Publication Type:Journal Article
- Keywords:
Cervical spondylotic myelopathy;
Hand dexterity;
Patient-reported outcome measures;
10-second Grip and Release Test;
Prediction model
- From:
Chinese Journal of Spine and Spinal Cord
2024;34(11):1130-1134
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To elucidate the temporal pattern of hand dexterity changes in patients with cervical spondylotic myelopathy(CSM)one year after decompression surgery and to develop and validate a predictive model for hand dexterity improvement.Methods:A total of 136 adult patients with CSM(70 males and 66 females;mean age 56.37±11.12 years)treated in our hospital were prospectively enrolled between October 2021 and October 2022.Hand dexterity was assessed using the 10-second grip and release(10-s G&R)test,the modified Japanese Orthopaedic Association(mJOA)upper extremity motor function score,and the JO A cer-vical myelopathy evaluation questionnaire(JOACMEQ)upper extremity function before operation,and at 6 and 12 months after operation.A one-way ANOVA was conducted to examine the temporal pattern of hand func-tion improvement.Logistic regression analysis was performed to identify risk factors and develop a predictive model for postoperative hand dexterity impairment.The model's discrimination was assessed using receiver op-erating characteristic(ROC)curve and area under curve(AUC)analysis.Results:At 6 months after operation,significant improvements were observed in mJOA score(from 13.09±2.42 to 16.64±1.42 分),mJOA upper extremity motor function score(from 3.90±0.89 to 4.77±0.48),JOACMEQ upper extremity function score(from 76.97±19.30 to 90.45±14.70),and 10-s G&R test result(from 14.41±3.14 cycles to 18.16±4.63 cycles)(all P＜0.001);At 12 months after operation,the 10-s G&R test result further increased to 18.16±4.63 cycles(P=0.038),though no significant changes were noted in the subjective scores.The cycles of preoperative 10-s G&R test,as well as age and smoking status,were identified as the risk factors for hand dexterity impairment one year after surgery.The prediction model was validated with an AUC of 0.780(95％CI=0.665-0.894).Conclusions:Regarding the hand function of CSM patients after decompression surgery,subjective measurements typically stabilize at 6 months,while objective measurements continue to improve at 1 year.Based on the cycles of preoperative 10-s G&R test,age,and smoking status,the improvement in the cycles of the 10-s G&R test one year post-surgery can be predicted.
