Correlation of Myelopathy to Regional Neck Disability: A Surgical Approach-Specific Analysis in 217 Patients
Introduction Outcomes for cervical spondylotic myelopathy (CSM) have been measured by numerous health-related quality of life (HRQOL) scales such as the disease-specific modified Japanese Orthopaedic Association (mJOA) and the regional-specific neck disability index (NDI). However, there is no liter...
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Published in | Global Spine Journal Vol. 5; no. 1_suppl; p. s-0035-1554528 |
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Main Authors | , , , , , , , , , , , , , , |
Format | Journal Article Conference Proceeding |
Language | English |
Published |
Los Angeles, CA
SAGE Publications
01.05.2015
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Online Access | Get full text |
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Summary: | Introduction
Outcomes for cervical spondylotic myelopathy (CSM) have been measured by numerous health-related quality of life (HRQOL) scales such as the disease-specific modified Japanese Orthopaedic Association (mJOA) and the regional-specific neck disability index (NDI). However, there is no literature analyzing the correlation of myelopathy improvement to regional neck disability changes after surgery.
Materials and Methods
Post hoc analysis of a prospective, multicenter database of patients with CSM. A total of 217 patients (78%) met the following inclusion criteria: symptomatic CSM, age over 18 years, and 6 months follow-up with mJOA and NDI. The patient population had a mean age of 57 years and 42% were females (n = 92). NDI and mJOA were analyzed at baseline and 6 months post-op for the entire group. Correlations were also analyzed by the following subgroups: anterior approach group (AAG, n = 141) and posterior approach group (PAG, n = 76).
Results
From baseline to 6 months, there was a statistically significant improvement in both mJOA (BL 12.87–6 M 15.25, p < 0.0001) and NDI (BL 42.25–6M 31.61, p < 0.0001) in the overall group. There was a significant small negative correlation between NDI and mJOA at baseline (R = − 0.34, p < 0.0001) and at 6-month follow-up (R = − 0.44, p < 0.0001). Within the AAG, there was also a significant negative correlation between NDI and mJOA at baseline (R = − 0.31, p < 0.0001) and 6 months (R = − 0.53, p < 0.0001). Within the PAG, there was also a significant negative correlation between NDI and mJOA at baseline (R = − 0.43, p < 0.0001) and 6 months (R = − 0.34, p = 0.003).
Conclusion
Overall, NDI has a significant negative correlation with mJOA at baseline and postoperatively in patients with CSM. This correlation increases postoperatively in the overall group. The PAG showed a decrease in the correlation coefficient after surgery, whereas the AAG showed an increase. This could be because the posterior approach tended to be a more extensive surgery for multilevel disease in older patients, compared with the anterior approach, resulting in more soft tissue disruption and a delay in neck active motion. Regardless of the approach, mJOA still remains significantly correlated with NDI. |
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ISSN: | 2192-5682 2192-5690 |
DOI: | 10.1055/s-0035-1554528 |