Alexander J Schupper, Joseph DiDomenico, S Harrison Farber, Sarah E Johnson, Erica F Bisson, Mohamad Bydon, Anthony L Asher, Domagoj Coric, Eric A Potts, Kevin T Foley, Michael Y Wang, Kai-Ming Fu, Michael S Virk, Christopher I Shaffrey, Oren N Gottfried, Christine Park, John J Knightly, Scott Meyer, Paul Park, Cheerag Upadhyaya, Mark E Shaffrey, Andrew K Chan, Luis M Tumialán, Dean Chou, Regis W Haid, Praveen V Mummaneni, Juan S Uribe, Jay D Turner
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In this paper, the authors explore predictors of patient satisfaction following surgical intervention for CSM.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. 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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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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. 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引用次数: 0
摘要
目的:颈椎病(CSM)患者的神经功能会逐渐受损。为了阻止神经症状的发展并恢复功能,患者通常会选择手术治疗。在本文中,作者探讨了CSM手术干预后患者满意度的预测因素:本文是对多中心质量结果数据库中前瞻性收集的数据进行的回顾性研究。纳入的患者均接受过 CSM 手术治疗,随访时间至少 2 年。患者报告的满意度定义为北美脊柱协会(NASS)满意度评分为1分或2分。评估了与患者满意度相关的患者人口统计学特征、手术参数和结果。在基线和 24 个月的时间点测量了患者的生活质量评分。使用卡方检验或学生 t 检验进行单变量回归分析,以评估患者满意度。进行多变量逻辑回归分析,以评估术后24个月满意度的预测因素:结果:14家医疗机构共纳入了1140名接受手术治疗的CSM患者,其中944人完成了术后24个月的患者满意度调查。基线改良日本骨科协会(mJOA)评分为 12.0 ± 2.8。2年后,共有793名(84.0%)患者表示满意(NASS评分为1分或2分)。男性和女性患者的满意度相似(女性:47.0% 不满意 vs 48.5% 满意,p = 0.73)。黑人患者的满意度较低(26.5% 不满意 vs 13.2%满意,p < 0.01)。基线精神病合并症、肥胖和住院时间与24个月的满意度没有关联。穿越颈胸交界处不会影响满意度评分(p = 0.19),微创方法与患者满意度的提高无关(p = 0.14)。较低的基线颈痛数字评分量表评分(5.03 vs 5.61,p = 0.04)和较高的基线mJOA评分(12.28 vs 11.66,p = 0.01)与较高的满意度有关:结论:手术治疗 CSM 可使患者在 2 年随访中获得较高的满意度(84.0%)。脊髓病变较轻的患者满意度较高,这表明在疾病早期进行干预可能会提高长期满意度。
Predictors of patient satisfaction in the surgical treatment of cervical spondylotic myelopathy.
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.
期刊介绍:
Primarily publish original works in neurosurgery but also include studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology.