Junichi Ohya1, Yasushi Oshima2, Hiroyuki Oka3, Fumiko Saiki2, Yuki Taniguchi2, Yoshitaka Matsubayashi2, Sakae Tanaka2, Hirotaka Chikuda2, Katsushi Takeshita4. 1. Department of Orthopedic Surgery, The University of Tokyo, Tokyo, Japan. Electronic address: jun.ohya@gmail.com. 2. Department of Orthopedic Surgery, The University of Tokyo, Tokyo, Japan. 3. Department of Medical Research and Management of Musculoskeletal Pain, The University of Tokyo, Tokyo, Japan. 4. Department of Orthopedic Surgery, The University of Tokyo, Tokyo, Japan; Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan.
Abstract
OBJECTIVE: 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). METHODS: The 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). RESULTS: The 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). CONCLUSION: Patient 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. Copyright Â
OBJECTIVE: 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). METHODS: The 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). RESULTS: The 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). CONCLUSION:Patient 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. Copyright Â