Patient satisfaction with surgery for cervical myelopathy due to ossification of the posterior longitudinal ligament Clinical article Clinical article
Patient satisfaction with surgery for cervical myelopathy due to ossification of the posterior longitudinal ligament Clinical article Clinical article
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DOI：
10.3171/2011.1.spine10649
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发表时间：
2011-06-01
影响因子：
2.8
通讯作者：
Yoshikawa, Hideki
中科院分区：
文献类型：
--
作者：
Fujimori, Takahito;Iwasaki, Motoki;Yoshikawa, Hideki
物体。由后纵韧带骨化(OPLL)引起的脊髓型颈椎病的手术结果，以患者为基础的方法尚未有报道。本研究的目的是调查脊髓型颈椎病患者对OPLL手术的满意度，并阐明影响满意度的相关因素。对103例(男74例，女29例)颈椎OPLL患者的临床资料进行了回顾分析。手术时平均年龄57岁，平均随访期9.3年。使用原始满意度问卷、传统的日本骨科协会(JOA)评分系统、JOA颈椎病评估问卷、36个项目的简表健康调查和医院焦虑和抑郁量表来评估结果。计算5个量表患者满意度与结果测量的Spearman等级相关系数，以检验变量之间的关系。所有变量在满意(非常满意或满意的反应)和不满意(不满意或非常不满意的反应)组之间进行比较。将两组间存在显著Spearman等级相关或差异的参数输入逐步Logistic回归分析模型，满意度为因变量。69名患者被纳入分析。这69名研究患者的临床数据与其他34名患者的临床数据没有显著差异。55名患者(80%)对手术结果感到满意，58名患者(84%)报告通过手术改善了他们的病情。所有报告有很大改善的患者要么非常满意，要么对手术结果感到满意。生活质量(QOL)、身体功能(PF)和角色身体(RP)与患者满意度显著相关。不满意组疼痛明显加重，常规JOA最大评分较低，最大恢复率较低，下肢功能(LEF)较差，生活质量降低，PF、RP和活力评分较低。逐步Logistic回归分析显示，PF、QOL、LEF和基于JOA评分的最大恢复率与满意度相关。80%的患者对OPLL治疗脊髓型颈椎病的手术效果满意。根据医生和患者的评估，颈椎OPLL的手术是有效的。患者满意度与QOL、PF(尤其是LEF)和改善有关。(DOI：10.3171/2011.1.SPINE10649)
Object. Surgical results in cervical myelopathy caused by ossification of the posterior longitudinal ligament (OPLL) evaluated with a patient-based method have not yet been reported. The purpose of this study was to examine patient satisfaction with surgery for cervical myelopathy due to OPLL and to clarify factors related to satisfaction.Methods. Clinical data in 103 patients (74 male and 29 female) who underwent surgery for cervical OPLL were retrospectively reviewed. The average age at surgery was 57 years, and the average follow-up period was 9.3 years. Outcomes were assessed using an original satisfaction questionnaire, the conventional Japanese Orthopaedic Association (JOA) scoring system, the JOA Cervical Myelopathy Evaluation Questionnaire, the 36-Item Short Form Health Survey, and the hospital anxiety and depression scale. Spearman rank correlation coefficients for 5-scale patient satisfaction against outcome measures were calculated to test relationships between variables. All variables were compared between the satisfied (responses of very satisfied or satisfied) and dissatisfied (responses of dissatisfied or very dissatisfied) groups. Parameters exhibiting a significant Spearman rank correlation or difference between the groups were entered in a stepwise logistic regression analysis model, with satisfaction as the dependent variable.Results. Sixty-nine patients were included in the analysis. There was not a significant difference in clinical data between these 69 study patients and the other 34 patients. Fifty-five patients (80%) were satisfied with the results of the surgery, and 58 patients (84%) reported that their condition was improved by the surgery. All patients who reported being very improved were either very satisfied or satisfied with the results of surgery. Quality of life (QOL), physical function (PF), and role physical (RP) were significantly correlated with patient satisfaction. The dissatisfied group had significantly more severe pain; lower maximum conventional JOA scores; lower maximum recovery rates; worse lower-extremity function (LEF); reduced QOL; and lower PF, RP, and vitality scores. Stepwise logistic regression analysis showed that PF, QOL, LEF, and maximum recovery rate based on JOA score were correlated with satisfaction.Conclusions. Eighty percent of patients were satisfied with the surgical results after treatment of cervical myelopathy due to OPLL. Surgery for cervical OPLL was effective, as evaluated by both doctor- and patient-based methods. Patient satisfaction was related to QOL, PF (especially LEF), and improvement. (DOI: 10.3171/2011.1.SPINE10649)