title: Patient satisfaction with surgery for cervical myelopathy due to ossification of the posterior longitudinal ligament.
abstract: OBJECTIVE
  Surgical results in cervical myelopathy caused by ossification of the posterior longitudinal ligament (OPLL) evaluated with a patient-based method have not yet been reported. The purpose of this study was to examine patient satisfaction with surgery for cervical myelopathy due to OPLL and to clarify factors related to satisfaction.
  
  
  METHODS
  Clinical data in 103 patients (74 male and 29 female) who underwent surgery for cervical OPLL were retrospectively reviewed. The average age at surgery was 57 years, and the average follow-up period was 9.3 years. Outcomes were assessed using an original satisfaction questionnaire, the conventional Japanese Orthopaedic Association (JOA) scoring system, the JOA Cervical Myelopathy Evaluation Questionnaire, the 36-Item Short Form Health Survey, and the hospital anxiety and depression scale. Spearman rank correlation coefficients for 5-scale patient satisfaction against outcome measures were calculated to test relationships between variables. All variables were compared between the satisfied (responses of very satisfied or satisfied) and dissatisfied (responses of dissatisfied or very dissatisfied) groups. Parameters exhibiting a significant Spearman rank correlation or difference between the groups were entered in a stepwise logistic regression analysis model, with satisfaction as the dependent variable.
  
  
  RESULTS
  Sixty-nine patients were included in the analysis. There was not a significant difference in clinical data between these 69 study patients and the other 34 patients. Fifty-five patients (80%) were satisfied with the results of the surgery, and 58 patients (84%) reported that their condition was improved by the surgery. All patients who reported being very improved were either very satisfied or satisfied with the results of surgery. Quality of life (QOL), physical function (PF), and role physical (RP) were significantly correlated with patient satisfaction. The dissatisfied group had significantly more severe pain; lower maximum conventional JOA scores; lower maximum recovery rates; worse lower-extremity function (LEF); reduced QOL; and lower PF, RP, and vitality scores. Stepwise logistic regression analysis showed that PF, QOL, LEF, and maximum recovery rate based on JOA score were correlated with satisfaction.
  
  
  CONCLUSIONS
  Eighty percent of patients were satisfied with the surgical results after treatment of cervical myelopathy due to OPLL. Surgery for cervical OPLL was effective, as evaluated by both doctor- and patient-based methods. Patient satisfaction was related to QOL, PF (especially LEF), and improvement.
authors.affiliation: Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. takahito-f@hotmail.co.jp
authors.forename: Takahito
authors.initials: T
authors.lastname: Fujimori
authors.forename: Motoki
authors.initials: M
authors.lastname: Iwasaki
authors.forename: Shinya
authors.initials: S
authors.lastname: Okuda
authors.forename: Yukitaka
authors.initials: Y
authors.lastname: Nagamoto
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sakaura
authors.forename: Takenori
authors.initials: T
authors.lastname: Oda
authors.forename: Hideki
authors.initials: H
authors.lastname: Yoshikawa
mesh_terms: D001007:Anxiety; D002574:Cervical Vertebrae / Q000601:surgery*; D003863:Depression; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000150:complications / Q000601:surgery*; D017060:Patient Satisfaction; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D013118:Spinal Cord Diseases / Q000209:etiology / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome