Evaluation of clinical results and quality of life after surgical reconstruction for rheumatoid cervical spine

摘要

Background context: The EuroQol (EQ-5D) is a widely used comprehensive measure of health-related quality of life. There has been no study that has evaluated the health-related quality of life before and after the surgical reconstruction of rheumatoid arthritis (RA) cervical spine lesions using EQ-5D. Purpose: The present study aimed to evaluate the improvement of quality of life before and after surgical reconstruction of rheumatoid cervical spine using EQ-5D, and the surgical outcomes of cervical spine affected by RA. Study design: A retrospective study of the patients who underwent surgical reconstruction of cervical disorders in RA. Patient sample: Twenty-five patients (seven men, 18 women, mean age 62.2 years) who underwent surgical reconstruction of cervical disorders in RA were enrolled. Outcome measures: Japanese Orthopaedic Association (JOA) score and EQ-5D. Methods: Clinical symptoms were evaluated before surgery and at 2 years after surgery by measuring the JOA score. We also investigated health-related quality of life before surgery and outcome at 2 years after surgery using the EQ-5D questionnaire. Results: Mean observation period was 46.3 months. Mean JOA score significantly improved from 9.1±4.5 points before surgery to 12.4±2.8 at the 2 years after surgery (p=.0001). All the EQ-5D data were improved at the 2 years after surgery, compared with the data before surgery; especially, pain (p=.005), usual activity (p=.005), mobility (p=.008), and anxiety/depression (p=.02) were significantly improved. Utility weight was 0.37±0.27 before surgery and 0.56±0.26 at the 2 years after surgery, showing significant improvement at the 2 years after surgery compared to before surgery (p=.002). Conclusions: The surgical reconstruction of rheumatoid cervical spine has been demonstrated to improve patients' health-related quality of life.