Comparing Quality of Life in Cervical Spondylotic Myelopathy with Other Chronic Debilitating Diseases Using the SF-36 Survey.

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Comparing Quality of Life in Cervical Spondylotic Myelopathy with Other Chronic Debilitating Diseases Using the SF-36 Survey.

World Neurosurg. 2017 Jan 05;:

Authors: Oh T, Lafage R, Lafage V, Protopsaltis T, Challier V, Shaffrey C, Kim HJ, Arnold P, Chapman J, Schwab F, Massicotte E, Yoon T, Bess S, Fehlings M, Smith J, Ames C

Abstract
BACKGROUND: Although cervical spondylotic myelopathy (CSM) can be devastating, its relative impact on general health remains unclear. Patient responses to the SF-36 PCS/MCS were compared between CSM and other diseases to evaluate their respective impacts on quality of life.
OBJECTIVE: Compare SF-36 PCS/MCS scores in CSM to population and disease-specific norms.
METHODS: Retrospective analysis of a prospective, multi-center AOSpine North American CSM Study database. Inclusion criteria were symptomatic disease, age>18, cord compression on MRI or CT myelography, and baseline SF-36 values. SF-36 PCS/MCS in CSM were compared to national normative values and disease-specific norms using student's t-test. ANOVA was used to assess differences across age groups and offsets from age-matched controls. Threshold for significance was p<0.05.
RESULTS: 285 patients met inclusion criteria. 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). While there were no differences across age groups, when compared to 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.
CONCLUSION: 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 similar caliber of healthy policy attention as more well-studied diseases.

PMID: 28065875 [PubMed - as supplied by publisher]

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