NDLI: Changes of improvement in upper limb function predict surgical outcome after laminoplasty in 1 year in patients with cervical spondylotic myelopathy: a retrospective study

Content Provider	Springer Nature : BioMed Central
Author	Fudo, Takuma Hashida, Ryuki Yokosuka, Kimiaki Sato, Kimiaki Hiraoka, Koji
Abstract	Background Cervical spondylotic myelopathy preoperative prognostic factors include age, preoperative severity, and disease duration. However, there are no reports on the relationship between changes in physical function during hospitalization and postoperative course, and in recent years, the length of hospital stay has shortened. We aimed to investigate whether changes in physical function during hospitalization can predict the postoperative outcome. Methods We recruited 104 patients who underwent laminoplasty for cervical spondylotic myelopathy by the same surgeon. Physical functions, including Simple Test for Evaluating Hand Function (STEF), grip strength, timed up and go test, 10-m walk, and time to stand on one leg, were assessed at admission and discharge. Patients with the Japanese Orthopaedic Association (JOA) score improvement rate of 50% or more were defined as the improved group. Decision tree analysis was investigated factor for identifying improvement in the JOA score. According to this analysis, we divided into two groups using age. Then, we conducted a logistic regression analysis to identify factors that improve the JOA score. Results The improved and non-improved groups had 31 and 73 patients, respectively. The improved group was younger (p = 0.003) and had better improved Δgrip strength (p = 0.001) and ΔSTEF (p < .0007). Age was significantly positively correlated with disease duration (r = 0.4881, p = < .001). Disease duration exhibited a significant negative correlation with the JOA score improvement rate (r = − 0.2127, p = 0.031). Based on the decision tree analysis results, age was the first branching variable, with 15% of patients ≥ 67 years showing JOA score improvement. This was followed by ΔSTEF as the second branching factor. ΔSTEF was selected as the factor associated with JOA improvement in patients ≥67 years (odds ratio (OR) 1.06, 95% confidence interval (CI) 1.01–1.12, p=.0268); in patients <67 years, Δgrip strength was identified (OR 1.30, CI 1.04‒1.62, p=.0049). Conclusions In the improved group, upper limb function improved more than lower limb function from the early postoperative period. Upper limb function changes during hospitalization were associated with outcomes one year postoperatively. Improvement factors in upper extremity function differed by age, with changes in grip strength in patients < 67 years and STEF in patients ≥ 67 years, reflecting the outcome at one year postoperatively.
Related Links	https://josr-online.biomedcentral.com/counter/pdf/10.1186/s13018-023-03805-6.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/s13018-023-03805-6
Journal	Journal of Orthopaedic Surgery and Research
Issue Number	1
Volume Number	18
Language	English
Publisher	BioMed Central
Publisher Date	2023-04-26
Access Restriction	Open
Subject Keyword	Orthopedics Surgical Orthopedics Upper limb function Surgical outcome Laminoplasty Cervical spondylotic myelopathy Simple Test for Evaluating Hand Function (STEF) Hand grip strength Hospitalization Japanese Orthopaedic Association (JOA) score
Content Type	Text
Resource Type	Article
Subject	Surgery Orthopedics and Sports Medicine
Journal Impact Factor	2.8/2023
5-Year Journal Impact Factor	3/2023

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Correction: Changes of improvement in upper limb function predict surgical outcome after laminoplasty in 1 year in patients with cervical spondylotic myelopathy: a retrospective study

Comparison Between the Japanese Orthopaedic Association (JOA) Score and Patient-Reported JOA (PRO-JOA) Score to Evaluate Surgical Outcomes of Degenerative Cervical Myelopathy

The japanese orthopaedic association.

Evaluation of Upper Extremity Functions Using the Simple Test for Evaluating Hand Function (STEF) in Cervical Myelopathy Patients

Prognostic factors that affect the surgical outcome of the laminoplasty in cervical spondylotic myelopathy.

Laminoplasty versus laminectomy for multi-level cervical spondylotic myelopathy: a systematic review of the literature

Comparison of the Japanese Orthopaedic Association (JOA) Score and Modified JOA (mJOA) Score for the Assessment of Cervical Myelopathy: A (2015)

Review of laminoplasty versus laminectomy in the surgical management of cervical spondylotic myelopathy.

Age-Related Surgical Outcomes of Laminoplasty for Cervical Spondylotic Myelopathy

Changes of improvement in upper limb function predict surgical outcome after laminoplasty in 1 year in patients with cervical spondylotic myelopathy: a retrospective study

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Correction: Changes of improvement in upper limb function predict surgical outcome after laminoplasty in 1 year in patients with cervical spondylotic myelopathy: a retrospective study

Comparison Between the Japanese Orthopaedic Association (JOA) Score and Patient-Reported JOA (PRO-JOA) Score to Evaluate Surgical Outcomes of Degenerative Cervical Myelopathy

The japanese orthopaedic association.

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Changes of improvement in upper limb function predict surgical outcome after laminoplasty in 1 year in patients with cervical spondylotic myelopathy: a retrospective study