PMID- 33156277
OWN - NLM
STAT- MEDLINE
DCOM- 20210427
LR  - 20210427
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 46
IP  - 5
DP  - 2021 Mar 1
TI  - Time Course of Physical and Mental Well-being Improvements After Cervical 
      Surgery.
PG  - E303-E309
LID - 10.1097/BRS.0000000000003787 [doi]
AB  - STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To elucidate the 
      postoperative time course of improvements in physical and mental well-being in 
      patients with cervical spondylotic myelopathy (CSM). SUMMARY OF BACKGROUND DATA: 
      Spinal surgeons should understand the postoperative course in detail. However, 
      data are still needed regarding the time course of improvements in well-being, a 
      fundamental aspect of human life, after cervical surgery for CSM. METHODS: One 
      hundred consecutive patients who underwent laminoplasty for CSM, with complete 
      clinical data preoperatively and 3 months and 2 years postoperatively, were 
      enrolled. The Short Form-36 physical component summary (PCS) and mental component 
      summary (MCS) scores were used as parameters of physical and mental well-being, 
      respectively, and 4.0 was defined as the minimal clinically important difference 
      (MCID) for both parameters. RESULTS: On average, PCS and MCS scores were 
      significantly improved after surgery (P < 0.001, P=0.004, respectively). 
      Moreover, 64 and 48 patients achieved meaningful improvement (>MCID) in PCS and 
      MCS scores at 3 months postoperatively, with maintained improvement (to 2 yr) in 
      46/64 (71.9%) and 34/48 patients (70.8%), respectively (PCS vs. MCS: P = 0.912). 
      Additionally, 15 of 36 patients (41.7%) and 8 of 52 patients (15.4%) achieved 
      late improvement (meaningful improvement at 2 yr but not at 3 months) in PCS and 
      MCS scores, respectively (PCS vs. MCS: P = 0.007). In multivariate regression 
      analysis, improvement in cJOA score was significantly associated with PCS 
      improvement, but not MCS improvement, at both 3 months and 2 years (P = 0.001, 
      P > 0.001, respectively). CONCLUSION: The overall outcome of physical well-being 
      improvement is decided within 3 months postoperatively, in proportion to the 
      recovery in myelopathy, with a relatively high chance of meaningful improvement 
      over the next 21 months. The outcome of improvement in mental well-being is 
      decided within 3 months postoperatively, independently from the recovery in 
      myelopathy, with a low chance of meaningful improvement over the next 21 
      months.Level of Evidence: 3.
CI  - Copyright (c) 2020 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Tamai, Koji
AU  - Tamai K
AD  - Department of Orthopedics, Osaka City University Graduate School of Medicine, 
      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 - 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/diagnosis/psychology/*surgery
MH  - Spondylosis/diagnosis/psychology/*surgery
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2020/11/07 06:00
MHDA- 2021/04/28 06:00
CRDT- 2020/11/06 12:12
PHST- 2020/11/07 06:00 [pubmed]
PHST- 2021/04/28 06:00 [medline]
PHST- 2020/11/06 12:12 [entrez]
AID - 00007632-202103010-00007 [pii]
AID - 10.1097/BRS.0000000000003787 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2021 Mar 1;46(5):E303-E309. doi: 
      10.1097/BRS.0000000000003787.