PMID- 31770327
OWN - NLM
STAT- MEDLINE
DCOM- 20200922
LR  - 20210115
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 45
IP  - 10
DP  - 2020 May 15
TI  - Improvement in Patient Mental Well-being After Surgery for Cervical Spondylotic 
      Myelopathy.
PG  - E568-E575
LID - 10.1097/BRS.0000000000003337 [doi]
AB  - STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The aim of this study was to 
      investigate changes in mental well-being after surgery for cervical spondylotic 
      myelopathy (CSM) and identify factors associated with improvement. SUMMARY OF 
      BACKGROUND DATA: Posterior cervical surgery with laminoplasty significantly 
      improves myelopathy and physical function in patients with CSM. However, its 
      impact on mental well-being is unclear. METHODS: Patients who underwent 
      laminoplasty for CSM and had >2 years of follow-up were reviewed (n = 111). The 
      mental component summary (MCS) score was used as a measure of mental well-being. 
      The trend in MCS score change was evaluated using the Jonckheere-Terpstra trend 
      test. Preoperative clinical scores were compared between patients with 
      improvements greater and less than the minimal clinically important difference 
      (MCID). Significant variables were included in a multinomial logistic regression 
      analysis and further validated in a receiver-operating characteristic (ROC) curve 
      analysis. Additionally, the results were confirmed in a long-term observation 
      cohort of patients followed up for >5 years (n = 46). RESULTS: The improvement in 
      the average MCS score (5.6) was greater than the MCID (4.0). The trend of 
      improvement was sustained for 2 years (P = 0.002), but not for 5 years 
      (P = 0.130). In terms of individual cases, 56 patients (50.5%) achieved MCS score 
      improvement greater than the MCID. These patients showed significantly lower 
      preoperative MCS scores than those without meaningful improvement (P < 0.001). 
      The preoperative "social functioning (SF)" score was independently associated 
      with MCS score improvement (P = 0.001). ROC curve analysis validated the ability 
      of preoperative SF to predict MCS score improvement at 2 and 5 years 
      postoperatively (area under the curve: 0.744, 0.893, respectively). CONCLUSION: 
      Half of the patients achieved meaningful improvement in mental well-being. A 
      lower preoperative SF score was independently associated with improvement. These 
      results may help identify patients who could experience an improvement in mental 
      well-being after surgery and develop novel approaches to achieve further 
      improvement. LEVEL OF EVIDENCE: 3.
FAU - Tamai, Koji
AU  - Tamai K
AD  - Department of Orthopedics, Osaka City University Graduate School of Medicine, 
      Asahimachi, Abenoku, Osaka, Japan.
FAU - Suzuki, Akinobu
AU  - Suzuki A
FAU - Terai, Hidetomi
AU  - Terai H
FAU - Hoshino, Masatoshi
AU  - Hoshino M
FAU - Toyoda, Hiromitsu
AU  - Toyoda H
FAU - Takahashi, Shinji
AU  - Takahashi S
FAU - Ohyama, Shoichiro
AU  - Ohyama S
FAU - Hori, Yusuke
AU  - Hori Y
FAU - Yabu, Akito
AU  - Yabu A
FAU - Nakamura, Hiroaki
AU  - Nakamura H
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cervical Vertebrae/*surgery
MH  - Cohort Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Laminoplasty/psychology/trends
MH  - Male
MH  - Mental Health/*trends
MH  - Middle Aged
MH  - Minimal Clinically Important Difference
MH  - Postoperative Care/psychology/trends
MH  - Retrospective Studies
MH  - Spinal Cord Diseases/*psychology/*surgery
MH  - Spondylosis/*psychology/*surgery
MH  - Treatment Outcome
EDAT- 2019/11/27 06:00
MHDA- 2020/09/23 06:00
CRDT- 2019/11/27 06:00
PHST- 2019/11/27 06:00 [pubmed]
PHST- 2020/09/23 06:00 [medline]
PHST- 2019/11/27 06:00 [entrez]
AID - 00007632-202005150-00007 [pii]
AID - 10.1097/BRS.0000000000003337 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2020 May 15;45(10):E568-E575. doi: 
      10.1097/BRS.0000000000003337.