Quality of life assessment with the medical outcomes study short form-36 among patients with cervical spondylotic myelopathy.
OBJECTIVE
Cervical spondylotic myelopathy (CSM) is a chronic degenerative condition of the cervical spine that produces narrowing of the spinal canal and disruption of spinal cord function. We used Medical Outcomes Study Short Form-36 (SF-36), a generic quality of life outcome-assessment instrument, to assess the quality of life among patients with CSM.


METHODS
A cohort of 88 Veterans Administration neurosurgery clinic patients with CSM underwent structured interviews for collection of data on demographic features, symptoms, operations, and comorbid diseases. Patients also completed the SF-36. Symptoms and examination findings were used to assign each patient scores on the Nurick, Cooper, and Harsh myelopathy scales and a Western modification of the Japanese Orthopaedic Association scale. SF-36 scores were compared with age-adjusted Veterans Administration population normative values by using Student's t test with unequal variances. Cuzick's nonparametric test for trend was used to explore the relationship between the SF-36 physical component summary scores and the myelopathy scale scores.


RESULTS
Patients with CSM exhibited decreased quality of life in all eight SF-36 domains, as well as with the physical and mental component summary scores, compared with Veterans Administration population normative values (for all, P </= 0.003). Lower physical component summary scores were associated with worse myelopathy scores on the Nurick scale (P < 0.001), Cooper leg subscale (P = 0.012), and Harsh scale (P < 0.001).


CONCLUSIONS
Patients with CSM exhibit decreased quality of life in all health domains assessed with the SF-36, a generic health outcome-measurement instrument. The impairments of patients with CSM extend beyond the motor, sensory, and bladder dysfunctions recorded with myelopathy scales, into the realms of emotional and mental health.
King
Joseph T
JT
Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA. Joseph.Kinglr@med.va.gov
McGinnis
Kathleen A
KA
Roberts
Mark S
MS
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D013117:Spinal Cord Compression / Q000175:diagnosis* / Q000523:psychology / Q000601:surgery; D013128:Spinal Osteophytosis / Q000175:diagnosis* / Q000523:psychology / Q000601:surgery