title: Comparing Quality of Life in Cervical Spondylotic Myelopathy with Other Chronic Debilitating Diseases Using the Short Form Survey 36-Health Survey.
abstract: BACKGROUND
  Although cervical spondylotic myelopathy (CSM) can be devastating, its relative impact on general health remains unclear. Patient responses to the Short Form Survey 36-Health Survey (SF-36) Physical Component Summary (PCS)/Mental Component Summary (MCS) were compared between CSM and other diseases to evaluate their respective impacts on quality of life. The objective of this study was to compare SF-36 PCS/MCS scores in CSM with population and disease-specific norms.
  
  
  METHODS
  Retrospective analysis of a prospective, multicenter AOSpine North American CSM Study database. Inclusion criteria were symptomatic disease, age older than 18 years, cord compression on magnetic resonance imaging or computed tomography myelography, and baseline SF-36 values. SF-36 PCS/MCS scores in CSM were compared with national normative values and disease-specific norms using Student t test. Analysis of variance was used to assess differences across age groups and offsets from age-matched controls. Threshold for significance was P < 0.05.
  
  
  RESULTS
  There were 285 patients who met the inclusion criteria. The mean age was 56.6 ± 12.0 years, with male predominance (60%). SF-36 scores revealed significant baseline disability (PCS: 34.5 ± 9.8; MCS: 41.5 ± 14.4). Although there were no differences across age groups, when compared with age-matched normative data, younger patients had a larger PCS offset than older patients. CSM caused worse physical disability than most diseases except heart failure. Only back pain/sciatica induced worse mental disability.
  
  
  CONCLUSIONS
  CSM affects quality of life to an extent greater than diabetes or cancer. Although mean impact of CSM does not vary with age, younger patients suffer from greater differences in baseline function. This study highlights the impact of myelopathy on patient function, particularly among younger age groups, and suggests that CSM merits a similar caliber of healthy policy attention as more well-studied diseases.
authors.affiliation: Department of Neurological Surgery, UCSF, San Francisco, California, USA. Electronic address: taemin.oh@ucsf.edu.
authors.forename: Taemin
authors.initials: T
authors.lastname: Oh
authors.affiliation: Hospital for Special Surgery, Department of Orthopaedic Surgery, New York, New York, USA.
authors.forename: Renaud
authors.initials: R
authors.lastname: Lafage
authors.affiliation: Hospital for Special Surgery, Department of Orthopaedic Surgery, New York, New York, USA.
authors.forename: Virginie
authors.initials: V
authors.lastname: Lafage
authors.affiliation: Department of Orthopaedic Surgery, NYU Langone Medical Center, New York, New York, USA.
authors.forename: Themistocles
authors.initials: T
authors.lastname: Protopsaltis
authors.affiliation: Department of Orthopaedic Surgery, NYU Langone Medical Center, New York, New York, USA.
authors.forename: Vincent
authors.initials: V
authors.lastname: Challier
authors.affiliation: Department of Neurological Surgery, University of Virginia, Charlottesville, New York, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Shaffrey
authors.affiliation: Hospital for Special Surgery, Department of Orthopaedic Surgery, New York, New York, USA.
authors.forename: Han Jo
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Neurological Surgery, The University of Kansas Hospital, Kansas City, Kansas, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Arnold
authors.affiliation: Swedish Medical Center, Department of Orthopaedic Surgery, Seattle, Washington, USA.
authors.forename: Jens
authors.initials: J
authors.lastname: Chapman
authors.affiliation: Hospital for Special Surgery, Department of Orthopaedic Surgery, New York, New York, USA.
authors.forename: Frank
authors.initials: F
authors.lastname: Schwab
authors.affiliation: Department of Neurological Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Massicotte
authors.affiliation: Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Tim
authors.initials: T
authors.lastname: Yoon
authors.affiliation: Department of Orthopaedic Surgery, NYU Langone Medical Center, New York, New York, USA.
authors.forename: Shay
authors.initials: S
authors.lastname: Bess
authors.affiliation: Department of Neurological Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Fehlings
authors.affiliation: Department of Neurological Surgery, University of Virginia, Charlottesville, New York, USA.
authors.forename: Justin
authors.initials: J
authors.lastname: Smith
authors.affiliation: Department of Neurological Surgery, UCSF, San Francisco, California, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Ames
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D003920:Diabetes Mellitus / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life; D012189:Retrospective Studies; D055009:Spondylosis / Q000523:psychology*; D055815:Young Adult
keywords: Cervical spondylotic myelopathy; Degenerative; Disability; Health care; Outcomes; Quality of life; SF-36