Predictors of patient satisfaction in the surgical treatment of cervical spondylotic myelopathy.

Autor:	Schupper AJ; 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona., DiDomenico J; 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona., Farber SH; 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona., Johnson SE; 2Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota., Bisson EF; 3Department of Neurological Surgery, University of Utah, Salt Lake City, Utah., Bydon M; 2Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota., Asher AL; 4Neuroscience Institute, Carolinas Healthcare System and Carolina Neurosurgery & Spine Associates, Charlotte, North Carolina., Coric D; 4Neuroscience Institute, Carolinas Healthcare System and Carolina Neurosurgery & Spine Associates, Charlotte, North Carolina., Potts EA; 5Goodman Campbell Brain and Spine, Indianapolis, Indiana., Foley KT; 6Department of Neurological Surgery, University of Tennessee, Semmes Murphey Neurologic and Spine Institute, Memphis, Tennessee., Wang MY; 7Department of Neurological Surgery, University of Miami, Florida., Fu KM; 8Department of Neurological Surgery, Weill Cornell Medical Center, New York, New York., Virk MS; 8Department of Neurological Surgery, Weill Cornell Medical Center, New York, New York., Shaffrey CI; Departments of9Neurosurgery and.; 10Orthopedic Surgery, Duke University, Durham, North Carolina., Gottfried ON; Departments of9Neurosurgery and., Park C; Departments of9Neurosurgery and., Knightly JJ; 11Maxim Spine, Cedar Knolls, New Jersey., Meyer S; 11Maxim Spine, Cedar Knolls, New Jersey., Park P; 6Department of Neurological Surgery, University of Tennessee, Semmes Murphey Neurologic and Spine Institute, Memphis, Tennessee., Upadhyaya C; 12Department of Neurosurgery, University of North Carolina, Chapel Hill, North Carolina., Shaffrey ME; 13Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia., Chan AK; 14Department of Neurological Surgery, Columbia University, The Och Spine Hospital at NewYork-Presbyterian, New York, New York., Tumialán LM; 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona., Chou D; 14Department of Neurological Surgery, Columbia University, The Och Spine Hospital at NewYork-Presbyterian, New York, New York., Haid RW; 15Atlanta Brain and Spine Care, Atlanta, Georgia; and., Mummaneni PV; 16Department of Neurological Surgery, University of California, San Francisco, California., Uribe JS; 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona., Turner JD; 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Spine [J Neurosurg Spine] 2024 Aug 16; Vol. 41 (5), pp. 611-618. Date of Electronic Publication: 2024 Aug 16 (Print Publication: 2024).
DOI:	10.3171/2024.5.SPINE24326
Abstrakt:	Objective: Patients with cervical spondylotic myelopathy (CSM) experience progressive neurological impairment. Surgical intervention is often pursued to halt neurological symptom progression and allow for recovery of function. In this paper, the authors explore predictors of patient satisfaction following surgical intervention for CSM. Methods: This is a retrospective review of prospectively collected data from the multicenter Quality Outcomes Database. Patients who underwent surgical intervention for CSM with a minimum follow-up of 2 years were included. Patient-reported satisfaction was defined as a North American Spine Society (NASS) satisfaction score of 1 or 2. Patient demographics, surgical parameters, and outcomes were assessed as related to patient satisfaction. Patient quality of life scores were measured at baseline and 24-month time points. Univariate regression analyses were performed using the chi-square test or Student t-test to assess patient satisfaction measures. Multivariate logistic regression analysis was conducted to assess for factors predictive of postoperative satisfaction at 24 months. Results: A total of 1140 patients at 14 institutions with CSM who underwent surgical intervention were included, and 944 completed a patient satisfaction survey at 24 months postoperatively. The baseline modified Japanese Orthopaedic Association (mJOA) score was 12.0 ± 2.8. A total of 793 (84.0%) patients reported satisfaction (NASS score 1 or 2) after 2 years. Male and female patients reported similar satisfaction rates (female sex: 47.0% not satisfied vs 48.5% satisfied, p = 0.73). Black race was associated with less satisfaction (26.5% not satisfied vs 13.2% satisfied, p < 0.01). Baseline psychiatric comorbidities, obesity, and length of stay did not correlate with 24-month satisfaction. Crossing the cervicothoracic junction did not affect satisfactory scores (p = 0.19), and minimally invasive approaches were not associated with increased patient satisfaction (p = 0.14). Lower baseline numeric rating scale neck pain scores (5.03 vs 5.61, p = 0.04) and higher baseline mJOA scores (12.28 vs 11.66, p = 0.01) were associated with higher satisfaction rates. Conclusions: Surgical treatment of CSM results in a high rate of patient satisfaction (84.0%) at the 2-year follow-up. Patients with milder myelopathy report higher satisfaction rates, suggesting that intervention earlier in the disease process may result in greater long-term satisfaction.
Databáze:	MEDLINE
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