Background
Methods
Study design and population
Treatment efficacy evaluation methods
-
mJOA assessment: This evaluation method, released by the Japanese Orthopaedic Association (JOA) on March 18, 1994, after several amendments, is used to evaluate spinal cord function of patients with CSM. The scores range from 0 to 17. The items evaluated are upper and lower extremity motor functions, sensory disturbances, and bladder function [9].
-
Health measurement scale (SF-36): The SF-36 is a concise health measurement scale that was developed by the American Institute of Health (in Boston, MA). From a quantitative perspective, this scale provides a more intuitive and comprehensive reflection of the health status of a population. The scale covers eight aspects of health-related QOL: physical function (PF), role-physical (RP), bodily pain (BP), general health (GH), vitality (VT), social function (SF), role-emotional (RE), and mental health (MH). For comparison, these eight sections can be categorized into two areas: SF-36 physical scores (PCS) and SF-36 mental scores (MCS). The health transition item (HTI), derived from the HTI of the SF-36, refers to how the patient feels at the time of the questionnaire compared with 1 year prior [10].
-
Peak recovery time: This measure was determined as the time point at which maximum recovery was obtained. It was evaluated for each patient. When the curve of the patient’s scores displayed double peaks, the earlier time point was considered the peak time.
Statistical analysis
Results
Age(years)
|
Mean = 60.0
|
Range = 32-90
| |
---|---|---|---|
Gender | Male = 84 (39.8%) | Female = 58 (60.2%) | |
Treatment | Posterior Approach | Laminoplasty | 74 |
Anterior approach | ACDF | 51 | |
Artificial Intervertebral Disk Implant | 10 | ||
ACCF | 7 | ||
mJOA | Mild | 82 | |
Moderate | 39 | ||
Severe | 21 |
SF-36 profile
Parameter
|
PF
|
RP
|
BP
|
GH
|
VT
|
SF
|
RE
|
MH
|
---|---|---|---|---|---|---|---|---|
Normal men
| 81.6 ± 17.3 | 82.3 ± 32.2 | 81.8 ± 20.0 | 56.2 ± 20.1 | 55.0 ± 21.5 | 81.8 ± 17.6 | 87.1 ± 17.6 | 65.8 ± 17.6 |
CSM men
| ||||||||
Preoperation {79) | 54.9 ± 24.7 | 16.5 ± 25.6 | 48.7 ± 24.4 | 46.5 ± 21.4 | 51.1 ± 19.8 | 51.5 ± 19.8 | 26.0 ± 32.2 | 64.3 ± 20.7 |
3-Months postoperation (72) | 71.5 ± 23.9 | 21.2 ± 31.6 | 54.3 ± 21.8 | 50.9 ± 21.8 | 52.9 ± 19.7 | 56.1 ± 27.1 | 42.5 ± 45.9 | 67.3 ± 20.2 |
1-Year postoperation (71) | 78.5 ± 19.2 | 40.5 ± 36.2 | 55.0 ± 21.8 | 45.4 ± 20.2 | 53.0 ± 20.4 | 63.6 ± 24.4 | 52.9 ± 38.5 | 69.7 ± 19.8 |
Final follow-up (83) | 77.4 ± 21.6 | 42.2 ± 40.2 | 55.5 ± 25.2 | 49.3 ± 21.9 | 52.1 ± 22.9 | 63.2 ± 25.8 | 54.5 ± 43.7 | 66.3 ± 20.8 |
Normal women
| 76.8 ± 18.9 | 77.6 ± 36.0 | 74.7 ± 25.5 | 50.9 ± 18.4 | 48.0 ± 18.8 | 83.2 ± 19.0 | 87.1 ± 35.8 | 65.8 ± 23.3 |
CSM women
| ||||||||
Preoperation (53) | 55.0 ± 20.7 | 20.6 ± 28.1 | 49.6 ± 21.6 | 45.8 ± 20.1 | 48.3 ± 22.3 | 50.3 ± 26.7 | 26.6 ± 29.8 | 60.6 ± 21.5 |
3-Months postoperation (54) | 65.7 ± 21.1 | 17.6 ± 29.8 | 45.1 ± 17.4 | 47.1 ± 20.0 | 48.8 ± 20.2 | 54.2 ± 22.8 | 32.7 ± 39.7 | 66.7 ± 18.4 |
1-Year postoperation (49) | 77.8 ± 19.3 | 37.8 ± 35.4 | 49.8 ± 17.9 | 43.6 ± 18.8 | 46.5 ± 20.1 | 61.2 ± 24.0 | 43.4 ± 38.5 | 64.6 ± 17.2 |
Final follow-up (57)) | 76.7 ± 21.6 | 37.0 ± 36.3 | 46.0 ± 19.8 | 43.8 ± 18.9 | 45.1 ± 21.3 | 58.3 ± 26.5 | 49.4 ± 45.8 | 61.6 ± 20.1 |
Psychometric evaluation
QOL measures: SF-36 scales
|
Lowest possible score (floor) (%)
|
Highest possible score (ceiling) (%)
|
Cronbach α
|
ES
|
---|---|---|---|---|
Physical function | 4 (3.03) | 1 (0.76) | 0.85 | 0.91 |
Role-physical | 13 (9.85) | 3 (2.27) | 0.83 | 0.93 |
Bodily pain | 2 (1.51) | 3 (2.27) | 0.80 | 0.57 |
General health | 0 | 1 (0.76) | 0.81 | 0.79 |
Vitality | 2 (1.51) | 1 (0.76) | 0.81 | 0.73 |
Social function | 1 (0.76) | 2 (1.51) | 0.79 | 0.74 |
Role-emotional | 21 (15.9) | 7 (5.30) | 0.73 | 0.82 |
Mental health | 1 (0.76) | 4 (3.03) | 0.75 | 0.77 |
Parameter
|
PCS
|
MCS
|
---|---|---|
ES | 0.84 | 0.81 |
MCID | 5.52 | 3.43 |
Cronbach α | 0.88 | 0.83 |
Lowest possible score (floor) | 0 | 0 |
Highest possible score (ceiling) | 0 | 0 |
Consistency between objective and subjective evaluations
Parameter
|
PF
|
RP
|
BP
|
GH
|
VT
|
SF
|
RE
|
MH
|
---|---|---|---|---|---|---|---|---|
CC (R) between preoperation and at 3 months after surgery (n = 116) | 0.32* | 0.04 | 0.20* | 0.18 | 0.09 | 0.17 | 0.04 | 0.13 |
CC (R) between preoperation and at 1 year after surgery (n = 110) | 0.39* | 0.08 | 0.15 | 0.24* | 0.13 | 0.22* | 0.19* | 0.08 |
CC (R) between preoperation and at final follow-up (n = 128) | 0.38* | 0.07 | 0.11 | 0.04 | 0.20* | 0.16 | 0.20* | 0.12 |