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


CONCLUSIONS
JOACMEQ offers an effective method of evaluation from the perspective of patient evaluations of QOL.
Nikaido
Takuya
T
Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan. tnikaido@fmu.ac.jp
Kikuchi
Shin-Ichi
S
Yabuki
Shoji
S
Otani
Koji
K
Konno
Shin-Ichi
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D012720:Severity of Illness Index; D013118:Spinal Cord Diseases / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome