title: Evaluation of clinical results and quality of life after surgical reconstruction for rheumatoid cervical spine.
abstract: BACKGROUND
  The EuroQol (EQ-5D) is a widely used comprehensive measure of health-related quality of life. There has been no study that has evaluated the health-related quality of life before and after the surgical reconstruction of rheumatoid arthritis (RA) cervical spine lesions using EQ-5D.
  
  
  OBJECTIVE
  The present study aimed to evaluate the improvement of quality of life before and after surgical reconstruction of rheumatoid cervical spine using EQ-5D, and the surgical outcomes of cervical spine affected by RA.
  
  
  METHODS
  A retrospective study of the patients who underwent surgical reconstruction of cervical disorders in RA.
  
  
  METHODS
  Twenty-five patients (seven men, 18 women, mean age 62.2 years) who underwent surgical reconstruction of cervical disorders in RA were enrolled.
  
  
  METHODS
  Japanese Orthopaedic Association (JOA) score and EQ-5D.
  
  
  METHODS
  Clinical symptoms were evaluated before surgery and at 2 years after surgery by measuring the JOA score. We also investigated health-related quality of life before surgery and outcome at 2 years after surgery using the EQ-5D questionnaire.
  
  
  RESULTS
  Mean observation period was 46.3 months. Mean JOA score significantly improved from 9.1 ± 4.5 points before surgery to 12.4 ± 2.8 at the 2 years after surgery (p=.0001). All the EQ-5D data were improved at the 2 years after surgery, compared with the data before surgery; especially, pain (p=.005), usual activity (p=.005), mobility (p=.008), and anxiety/depression (p=.02) were significantly improved. Utility weight was 0.37 ± 0.27 before surgery and 0.56 ± 0.26 at the 2 years after surgery, showing significant improvement at the 2 years after surgery compared to before surgery (p=.002).
  
  
  CONCLUSIONS
  The surgical reconstruction of rheumatoid cervical spine has been demonstrated to improve patients' health-related quality of life.
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto-city, Nagano 390-8621, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Uehara
authors.forename: Jun
authors.initials: J
authors.lastname: Takahashi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hirabayashi
authors.forename: Nobuhide
authors.initials: N
authors.lastname: Ogihara
authors.forename: Keijiro
authors.initials: K
authors.lastname: Mukaiyama
authors.forename: Shugo
authors.initials: S
authors.lastname: Kuraishi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Shimizu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hashidate
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kato
mesh_terms: D001172:Arthritis, Rheumatoid / Q000601:surgery*; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D016896:Treatment Outcome