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Predictors for quality of life improvement after surgery for degenerative cervical myelopathy: a prospective multi-center study

BACKGROUND: Degenerative 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. METHODS: This study included 148 patients who underwent surgery for DCM. The European Q...

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Autores principales: Inose, Hiroyuki, Hirai, Takashi, Yoshii, Toshitaka, Kimura, Atsushi, Takeshita, Katsushi, Inoue, Hirokazu, Maekawa, Asato, Endo, Kenji, Miyamoto, Takuya, Furuya, Takeo, Nakamura, Akira, Mori, Kanji, Kanbara, Shunsuke, Imagama, Shiro, Seki, Shoji, Matsunaga, Shunji, Okawa, Atsushi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8132343/
https://www.ncbi.nlm.nih.gov/pubmed/34011361
http://dx.doi.org/10.1186/s12955-021-01789-7
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author Inose, Hiroyuki
Hirai, Takashi
Yoshii, Toshitaka
Kimura, Atsushi
Takeshita, Katsushi
Inoue, Hirokazu
Maekawa, Asato
Endo, Kenji
Miyamoto, Takuya
Furuya, Takeo
Nakamura, Akira
Mori, Kanji
Kanbara, Shunsuke
Imagama, Shiro
Seki, Shoji
Matsunaga, Shunji
Okawa, Atsushi
author_facet Inose, Hiroyuki
Hirai, Takashi
Yoshii, Toshitaka
Kimura, Atsushi
Takeshita, Katsushi
Inoue, Hirokazu
Maekawa, Asato
Endo, Kenji
Miyamoto, Takuya
Furuya, Takeo
Nakamura, Akira
Mori, Kanji
Kanbara, Shunsuke
Imagama, Shiro
Seki, Shoji
Matsunaga, Shunji
Okawa, Atsushi
author_sort Inose, Hiroyuki
collection PubMed
description BACKGROUND: Degenerative 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. METHODS: This 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. RESULTS: The 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. CONCLUSIONS: Preoperative 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.
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spelling pubmed-81323432021-05-19 Predictors for quality of life improvement after surgery for degenerative cervical myelopathy: a prospective multi-center study Inose, Hiroyuki Hirai, Takashi Yoshii, Toshitaka Kimura, Atsushi Takeshita, Katsushi Inoue, Hirokazu Maekawa, Asato Endo, Kenji Miyamoto, Takuya Furuya, Takeo Nakamura, Akira Mori, Kanji Kanbara, Shunsuke Imagama, Shiro Seki, Shoji Matsunaga, Shunji Okawa, Atsushi Health Qual Life Outcomes Research BACKGROUND: Degenerative 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. METHODS: This 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. RESULTS: The 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. CONCLUSIONS: Preoperative 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. BioMed Central 2021-05-19 /pmc/articles/PMC8132343/ /pubmed/34011361 http://dx.doi.org/10.1186/s12955-021-01789-7 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Inose, Hiroyuki
Hirai, Takashi
Yoshii, Toshitaka
Kimura, Atsushi
Takeshita, Katsushi
Inoue, Hirokazu
Maekawa, Asato
Endo, Kenji
Miyamoto, Takuya
Furuya, Takeo
Nakamura, Akira
Mori, Kanji
Kanbara, Shunsuke
Imagama, Shiro
Seki, Shoji
Matsunaga, Shunji
Okawa, Atsushi
Predictors for quality of life improvement after surgery for degenerative cervical myelopathy: a prospective multi-center study
title Predictors for quality of life improvement after surgery for degenerative cervical myelopathy: a prospective multi-center study
title_full Predictors for quality of life improvement after surgery for degenerative cervical myelopathy: a prospective multi-center study
title_fullStr Predictors for quality of life improvement after surgery for degenerative cervical myelopathy: a prospective multi-center study
title_full_unstemmed Predictors for quality of life improvement after surgery for degenerative cervical myelopathy: a prospective multi-center study
title_short Predictors for quality of life improvement after surgery for degenerative cervical myelopathy: a prospective multi-center study
title_sort predictors for quality of life improvement after surgery for degenerative cervical myelopathy: a prospective multi-center study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8132343/
https://www.ncbi.nlm.nih.gov/pubmed/34011361
http://dx.doi.org/10.1186/s12955-021-01789-7
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