Preoperative Predictors of Patient Satisfaction with Outcome after Cervical Laminoplasty

Abstract

Study design Prospective cohort study. Objective The purpose of the present study was to identify the predictors of patient satisfaction with outcome after cervical laminoplasty for compressive cervical myelopathy. Methods A cohort of 143 patients with compressive myelopathy who underwent cervical double-door laminoplasty between 2008 and 2011 was studied prospectively. The principal outcome was patient satisfaction with outcome at 1 year after surgery. Patient satisfaction was graded on an ordinal scale from 1 to 7. Subjective health-related quality of life (QOL) and objective disease-specific outcome was measured by Short Form-36 (SF-36) and the Japanese Orthopaedic Association (JOA) score, respectively, before surgery and at 1-year follow-up. We evaluated the association between patient satisfaction at 1-year follow-up and various baseline parameters, including patient demographics, duration of symptoms, comorbidities, imaging findings, JOA score, and SF-36 scores. Results A total of 116 patients completed subjective and objective follow-up for a minimum of 1 year. Of 116 patients, 95 patients (81.9%) were satisfied with the outcome (“satisfied a little” or more). The unsatisfied group (“neutral” or less) showed significantly lower baseline SF-36 scores in bodily pain (BP), general health perceptions (GH), and vitality (VT) domains compared with the satisfied group. At the 1-year follow-up, SF-36 scores showed significant differences between the groups in all eight domains, whereas the JOA score showed no significant difference. Conclusions Lower baseline QOL measured by SF-36 scores, specifically in BP, GH, and VT domains, are associated with lower satisfaction with outcome after cervical laminoplasty.