Surgical treatment assessment using the Japanese orthopedic association cervical myelopathy evaluation questionnaire in patients with cervical myelopathy: a new outcome measure for cervical myelopathy.

摘要

STUDY DESIGN: Prospective study of assessment of surgical results using a new outcome measure for cervical myelopathy, the Japanese Orthopedic Association cervical myelopathy evaluation questionnaire (JOACMEQ). OBJECTIVE: To clarify correlations between pre- and postoperative JOACMEQ severity scores for cervical spine operations and grip strength and grip-and-release test, as objective evaluations, as well as correlations with the 8 subscales of the short form-36 (SF-36). METHODS: For pre- and postoperative evaluations, we examined 87 subjects who had undergone cervical spine operations and could be followed up for > or =6 months. JOACMEQ and the Japanese version of SF-36 were administered along with grip strength and grip-and-release tests, immediately preoperatively and 6 months postoperatively. Based on JOACMEQ severity scores pre- and postoperatively, treatment effectiveness was determined for cervical spine function, upper extremity function, lower extremity function, bladder function, and quality of life (QOL). We also clarified correlations between JOACMEQ scores and upper extremity function using grip strength and the grip-and-release test. In addition, correlations between the 5 JOACMEQ severity scores and the 8 subscales of SF-36 were analyzed. RESULTS: Effective rate of treatment was lower for upper extremity function than for other items (i.e., lower extremity function, bladder function, and QOL), and upper extremity function showed a different tendency for subjective improvement of symptoms following surgery compared to other items. JOACMEQ scores for upper extremity function, as subjective evaluations, may not necessarily improve even though improvements are seen in objective indicators such as grip strength and grip-and-release tests. CONCLUSION: JOACMEQ offers an effective method of evaluation from the perspective of patient evaluations of QOL.