Profiles of and correlation between objective and subjective outcome assessments following open-door laminoplasty for cervical spondylotic myelopathy
摘要Background Open-door laminoplasty is widely used in the treatment of cervical spondylotic myelopathy (CSM).This study aimed to investigate the profiles of and correlation between objective and subjective short-term outcome assessments after open-door laminoplasty for CSM.Methods We retrospectively analyzed surgical outcomes in 129 consecutive CSM patients who underwent open-door laminoplasty in Peking University Third Hospital from February 2008 to November 2011.Both objective and subjective assessments were evaluated before surgery,3 months after surgery,and 1 year after surgery.We then analyzed the profiles of and correlation between objective and subjective short-term outcomes.Results The Modified Japanese Orthopaedic Association (mJOA) score was significantly improved at 3 months (P<0.01) and 1 year (P<0.01) after surgery.Bivariate Logistic regression showed that sensory improvement contributed more to the recovery rate than motor function improvement at 3 months after surgery,while motor function contributed more to the recovery rate at 1 year after surgery.On the subjective assessment (the short form (SF)-36),there was no significant improvement at 3 months after surgery (P>0.05),while physical function (PF),role-physical (RP),and social function (SF) were notably improved at 1 year after surgery (P<O.01).Improved mJOA score correlated with improvements in PF,RP,bodily pain,general health (GH),vitality (VT),and SF (P<O.05) at 3 months after surgery; PF,GH,VT,and SF were associated with improved mJOA scores at 1 year after surgery.Conclusions Patients benefit from surgery by postoperative restitution of neurological function with early recovery of sensory function,followed by a gradual transition to motor function improvement.At the early stage of recovery,improvement in the mJOA score essentially correlated with improvements in the physical domains of the SF-36,while at the later stage,mJOA score improvement was associated with improvements in both mental and physical domains of the SF-36.
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