title: Patient Satisfaction with Posterior Decompression Surgery for Cervical Ossification of the Posterior Longitudinal Ligament: Prognostic Radiographic Factors and Patient-Reported Outcomes for the Effectiveness of Surgical Treatment.
abstract: OBJECTIVE
  To identify the prognostic factors associated with patient satisfaction after double-door laminoplasty for cervical compression myelopathy due to ossification of the posterior longitudinal ligament (OPLL).
  
  
  METHODS
  The study group comprised 44 patients (30 males and 14 females) with OPLL who underwent double-door laminoplasty at our institution with a minimum follow-up of 1 year. The mean patient age was 63.8 years (range, 48-86 years). We evaluated the patients' postoperative satisfaction using a questionnaire and divided them into 2 groups, satisfied and dissatisfied. We assessed various radiographic parameters. The patient-reported outcomes, including the Short Form-36 Physical Component Summary (SF-36 PCS), Neck Disability Index, neck pain, arm pain, and Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), were assessed and used to evaluate the effectiveness of surgical treatment according to the concept of minimum clinically important difference (MCID).
  
  
  RESULTS
  The satisfied group comprised 29 patients (65.9%). The dissatisfied group had a higher percentage of hill-shaped ossifications compared with the satisfied group (46.7% vs 17.2%; P = 0.04). The satisfied group had a higher proportion of patients with SF-36 PCS reaching the MCID threshold value (81.8% vs 14.3%; P < 0.01) and with effective surgical treatment as evaluated by the JOACMEQ lower extremity function domain (61.5% vs 10.0%; P < 0.01).
  
  
  CONCLUSIONS
  Patient satisfaction after laminoplasty was insufficient in patients with a hill-shaped ossification. The patients with OPLL who were able to recognize a difference in their clinical physical function, especially lower extremity function, were satisfied after laminoplasty.
authors.affiliation: Department of Orthopedic Surgery, The University of Tokyo, Tokyo, Japan. Electronic address: jun.ohya@gmail.com.
authors.forename: Junichi
authors.initials: J
authors.lastname: Ohya
authors.affiliation: Department of Orthopedic Surgery, The University of Tokyo, Tokyo, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Oshima
authors.affiliation: Department of Medical Research and Management of Musculoskeletal Pain, The University of Tokyo, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Oka
authors.affiliation: Department of Orthopedic Surgery, The University of Tokyo, Tokyo, Japan.
authors.forename: Fumiko
authors.initials: F
authors.lastname: Saiki
authors.affiliation: Department of Orthopedic Surgery, The University of Tokyo, Tokyo, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Taniguchi
authors.affiliation: Department of Orthopedic Surgery, The University of Tokyo, Tokyo, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Matsubayashi
authors.affiliation: Department of Orthopedic Surgery, The University of Tokyo, Tokyo, Japan.
authors.forename: Sakae
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of Orthopedic Surgery, The University of Tokyo, Tokyo, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Chikuda
authors.affiliation: Department of Orthopedic Surgery, The University of Tokyo, Tokyo, Japan; Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Katsushi
authors.initials: K
authors.lastname: Takeshita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D019299:Decompression, Surgical / Q000379:methods*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D065406:Laminoplasty / Q000379:methods / Q000523:psychology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000000981:diagnostic imaging / Q000523:psychology / Q000601:surgery; D000071066:Patient Reported Outcome Measures; D017060:Patient Satisfaction; D018709:Statistics, Nonparametric; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome
keywords: Cervical myelopathy; Laminoplasty; Minimum clinically important difference; Ossification of the posterior longitudinal ligament; Patient satisfaction; Surgical outcome