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Abstract
BackgroundDegenerative cervical myelopathy (DCM) can significantly impair a patient’s quality of life (QOL). In this study, we aimed to identify predictors associated with QOL improvement after surgery for DCM.MethodsThis study included 148 patients who underwent surgery for DCM. The European QOL-5 Dimension (EQ-5D) score, the Japanese Orthopedic Association for the assessment of cervical myelopathy (C-JOA) score, and the Nurick grade were used as outcome measures. Radiographic examinations were performed at enrollment. The associations of baseline variables with changes in EQ-5D scores from preoperative to 1-year postoperative assessment were investigated using a multivariable linear regression model.ResultsThe EQ-5D and C-JOA scores and the Nurick grade improved after surgery (P < 0.001, P < 0.001, and P < 0.001, respectively). Univariable analysis revealed that preoperative EQ-5D and C-JOA scores were significantly associated with increased EQ-5D scores from preoperative assessment to 1 year after surgery (P < 0.0001 and P = 0.045). Multivariable regression analysis showed that the independent preoperative predictors of change in QOL were lumbar lordosis (LL), sacral slope (SS), and T1 pelvic angle (TPA). According to the prediction model, the increased EQ-5D score from preoperatively to 1 year after surgery = 0.308 − 0.493 × EQ-5D + 0.006 × LL − 0.008 × SS + 0.004 × TPA.ConclusionsPreoperative LL, SS, and TPA significantly impacted the QOL of patients who underwent surgery for DCM. Less improvement in QOL after surgery was achieved in patients with smaller LL and TPA and larger SS values. Patients with these risk factors may therefore require additional support to experience adequate improvement in QOL.
Highlights
Degenerative cervical myelopathy (DCM) is the most common cause of spinal dysfunction in adults [1]
We examined whether the amount of change in European quality of life (QOL)-5 Dimension (EQ-5D) score was different among the three surgeries
The results showed no significant differences in EQ-5D score and change in EQ-5D score before and after surgery among the three surgeries (Table 3)
Summary
Degenerative cervical myelopathy (DCM) is the most common cause of spinal dysfunction in adults [1]. DCM is caused by age-related changes in the spine, including degeneration of the facet joints, discs, and/or vertebral bodies, progressive spinal kyphosis, and ossification, calcification, or thickening of the spinal ligaments [1]. These anatomical changes narrow the spinal canal, resulting in. There is still insufficient evidence regarding the extent of improvement in QOL after surgery for DCM using validated patient-based assessments [11]. This study aimed to identify the factors that influence the improvement of QOL after surgery for DCM patients based on European QOL-5 Dimension (EQ-5D) score assessments. We aimed to identify predictors associated with QOL improvement after surgery for DCM
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