Patient Satisfaction with Posterior Decompression Surgery for Cervical Ossification of the Posterior Longitudinal Ligament: Prognostic Radiographic Factors and Patient-Reported Outcomes for the Effectiveness of Surgical Treatment

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• 作者：Junichi Ohya¹ ; ^{jun.ohya@gmail.com} ; Yasushi Oshima¹ ; Hiroyuki Oka² ; Fumiko Saiki¹ ; Yuki Taniguchi¹ ; Yoshitaka Matsubayashi¹ ; Sakae Tanaka¹ ; Hirotaka Chikuda¹ ; Katsushi Takeshita¹ ; ³
• 关键词：Cervical myelopathy ; Laminoplasty ; Minimum clinically important difference ; Ossification of the posterior longitudinal ligament ; Patient satisfaction ; Surgical outcome
• 刊名：World Neurosurgery
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：96
• 期：Complete
• 页码：272-279
• 全文大小：3078 K
• 卷排序：96

文摘

To identify the prognostic factors associated with patient satisfaction after double-door laminoplasty for cervical compression myelopathy due to ossification of the posterior longitudinal ligament (OPLL).MethodsThe study group comprised 44 patients (30 males and 14 females) with OPLL who underwent double-door laminoplasty at our institution with a minimum follow-up of 1 year. The mean patient age was 63.8 years (range, 48–86 years). We evaluated the patients' postoperative satisfaction using a questionnaire and divided them into 2 groups, satisfied and dissatisfied. We assessed various radiographic parameters. The patient-reported outcomes, including the Short Form-36 Physical Component Summary (SF-36 PCS), Neck Disability Index, neck pain, arm pain, and Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), were assessed and used to evaluate the effectiveness of surgical treatment according to the concept of minimum clinically important difference (MCID).ResultsThe satisfied group comprised 29 patients (65.9%). The dissatisfied group had a higher percentage of hill-shaped ossifications compared with the satisfied group (46.7% vs 17.2%; P = 0.04). The satisfied group had a higher proportion of patients with SF-36 PCS reaching the MCID threshold value (81.8% vs 14.3%; P < 0.01) and with effective surgical treatment as evaluated by the JOACMEQ lower extremity function domain (61.5% vs 10.0%; P < 0.01).ConclusionPatient satisfaction after laminoplasty was insufficient in patients with a hill-shaped ossification. The patients with OPLL who were able to recognize a difference in their clinical physical function, especially lower extremity function, were satisfied after laminoplasty.