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Prediction of outcome following laminoplasty of cervical spondylotic myelopathy: Focus on the minimum clinically important difference
- Source :
- Journal of Clinical Neuroscience. 81:321-327
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- The minimum clinically important difference (MCID) of the Japanese Orthopaedic Association (JOA) score has been reported to be around 2.5 points in cervical myelopathy. This study sought to define significant predictive factors on achieving the MCID following laminoplasty in a large series of patients with cervical spondylotic myelopathy (CSM). A total of 485 consecutive patients with CSM (295 males and 190 females; mean age: 67.0 years; age range: 42-91 years) who underwent laminoplasty were prospectively enrolled. The average postoperative follow-up period was 26.6 months (range: 12-66 months). We calculated the achieved JOA score. The relationships between outcomes and various clinical and imaging predictors including comorbidity and quantitative performance tests were examined. Logistic regression analysis was conducted to identify the predictors correlated with a JOA score of 2.5 points or more. Clinically meaningful gains were exhibited in 299 patients (61.6%) with a JOA score of ≥2.5 points, whereas 186 patients (38.4%) achieved a JOA score of2.5 points. Univariate logistic regression analysis showed the predictive factors with a shorter duration of CSM symptoms, lower preoperative JOA scores, absence of hypertension, no use of anticoagulant/antiplatelet agents, and nonsmoking status. Multivariate logistic regression analysis determined that the duration of CSM symptoms (odds ratio: 0.771, 95% confidence interval: 0.705-0.844; p 0.01) was the only significant predictive factor for achieving JOA scores of ≥2.5 points. An important predictor of MCID achievement following laminoplasty was shorter duration of CSM symptoms.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
Multivariate analysis
medicine.medical_treatment
Logistic regression
Spinal Cord Diseases
Laminoplasty
03 medical and health sciences
Myelopathy
0302 clinical medicine
Predictive Value of Tests
Risk Factors
Physiology (medical)
Spondylotic myelopathy
Humans
Medicine
Prospective Studies
Aged
Aged, 80 and over
business.industry
Minimal clinically important difference
Mean age
Recovery of Function
General Medicine
Middle Aged
medicine.disease
Comorbidity
humanities
Surgery
Treatment Outcome
Neurology
030220 oncology & carcinogenesis
Cervical Vertebrae
Female
Spondylosis
Neurology (clinical)
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 09675868
- Volume :
- 81
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Neuroscience
- Accession number :
- edsair.doi.dedup.....1957fedf871636a40da2ebcb72009f07