Usefulness of QuickDASH in patients with cervical laminoplasty.
Usefulness of QuickDASH in patients with cervical laminoplasty.
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QuickDASH 在颈椎椎板成形术患者中的作用。
DOI：
10.1007/s00776-013-0515-x
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发表时间：
2014
期刊：
影响因子：
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通讯作者：
Tanaka S.
中科院分区：
文献类型：
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作者：
Nakamoto H;Oshima Y;Takeshita K;Chikuda H;Ono T;Taniguchi Y;Tanaka S.
目的上肢笨拙麻木是脊髓型颈椎病患者最常见的主诉之一。然而，以往大多数颈椎板成形术后的评估都只是基于医生的观点。采用QuickDASH自评量表对上肢疾患患者的躯体功能和症状进行测评，评价椎板成形术后患者的功能恢复情况。平均年龄62岁，平均随访期61个月。采用日本骨科学会(JOA)评分、颈部残疾指数(NDI)、36个问题的简式健康问卷(PCS)、上肢疼痛(数字评定量表)和QuickDASH(0~100，0表示最轻)来评估手术效果。同时调查患者对治疗的满意度，评价患者的内部一致性和效标相关效度。通过受试者操作特征曲线(ROC)分析确定患者满意度的QuickDASH临界值。结果手术前后平均JOA总分为10分，术后QuickDASH评分平均为30分。QuickDASH的克朗巴赫α为0.94.QuickDASH与上肢运动和感觉、NDI、PCS和疼痛的JOA评分显著相关。经ROC分析，QuickDASH的临界值为34.0。对治疗满意的患者的QuickDASH评分明显高于不满意的患者，而上肢运动功能的JOA评分没有显著差异。讨论QuickDASH与疾病特定的JOA评分和其他一般性结果指标有显著相关性。此外，QuickDASH能显著反映患者对治疗的满意度，而上肢运动功能的JOA评分不能反映患者对治疗的满意度。结论QuickDASH可用于评价颈椎板成形术后患者上肢功能状况。
PurposeClumsiness and numbness of the upper extremity is one of the most common complaints of patients with cervical myelopathy. However, most previous evaluations after cervical laminoplasty have only been based on physicians’ points of view. We used Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) self-report questionnaire, which was designed to measure physical function and symptoms in people with upper-limb disorders to evaluate functional outcomes after laminoplasty.MethodsNinety-four patients who underwent laminoplasty for cervical myelopathy and replied to the questionnaire were included in this study. The average age was 62 years, and mean follow-up period was 61 months. The Japanese Orthopedic Association (JOA) score, Neck Disability Index (NDI), Short-Form Health Questionnaire of 36 questions (physical component score, PCS), upper-extremity pain (Numerical Rating Scale), and QuickDASH (0–100, 0 being least severe) were used to evaluate surgical outcomes. Satisfaction with treatment was also investigated, and internal consistency and criterion-related validity were evaluated. The QuickDASH cutoff value for patient satisfaction was determined by receiver operating characteristic curve (ROC) analysis.ResultsThe mean total JOA scores were 10 before and 13 after surgery, and average postoperative QuickDASH score was 30. Cronbach α of the QuickDASH was 0.94. QuickDASH was significantly correlated with JOA score for upper-extremity motor and sensation, NDI, PCS, and pain. Cutoff value of the QuickDASH was 34.0 by ROC analysis. Significantly better QuickDASH scores were found for patients who were satisfied with treatment than for those who were not, whereas JOA score for upper-extremity motor function did not show a significant difference.DiscussionQuickDASH had significant correlations with disease-specific JOA scores and other generic outcome measures. Moreover, QuickDASH significantly reflected patients’ satisfaction with treatment, whereas the JOA score for upper-extremity motor function did not.ConclusionQuickDASH was useful in evaluating upper-extremity functional outcomes after cervical laminoplasty.