Document Detail


Comparison of short-term SF-36 results between total joint arthroplasty and cervical spine decompression and fusion or arthroplasty.
MedLine Citation:
PMID:  19139668     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: Cohort comparison of results of meta-analysis. OBJECTIVE: To compare improvement in SF-36 after cervical spine surgery to total hip and joint arthroplasty. SUMMARY OF BACKGROUND DATA: Health-related quality of life outcome instruments allow comparison of different diseases and change with various treatments. Total hip and knee arthroplasty are accepted procedures with excellent outcomes. It is unknown if treatment of cervical spine disease approaches those results. METHODS: A meta-analysis of SF-36 outcomes of total hip and knee arthroplasty was performed and compared to results after cervical discectomy and arthroplasty or fusion. Pooled means and SD were calculated and compared among treatment groups using analysis of variance. RESULTS: Eighteen studies reporting results in patients having total hip and knee arthroplasty and 2 randomized controlled studies of cervical disc arthroplasty were identified. The baseline physical function was worse in the joint arthroplasty patients and the mental health scores were worse in the cervical spine patients. The mean improvements in PCS for disc, fusion, total hip, and total knee arthroplasty were 14.2, 12.5, 12.2, and 9.6, respectively. The improvement in the physical component score (SF-36) was significantly greater in the cervical arthroplasty compared to the other 3 groups. Cervical fusion improvement was similar to total hip arthroplasty and both were greater than total knee arthroplasty. MCS domain improvement was significantly better in the cervical spine groups. CONCLUSION: The SF-36 results were surprising and showed equal or greater short-term improvement in cervical spine patient's pain and function than that observed after joint arthroplasty, although all groups had substantial improvement. Greater MCS improvement was likely caused by a ceiling effect as joint arthroplasty on average had normal scores at baseline.
Authors:
Paul A Anderson; Thomas J Puschak; Rick C Sasso
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Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Spine     Volume:  34     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-13     Completed Date:  2009-04-09     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  176-83     Citation Subset:  IM    
Affiliation:
Department of Orthopedic Surgery and Rehabilitation, University of Wisconsin, Madison WI 53792, USA. anderson@orthorehab.wisc.edu
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Arthroplasty / statistics & numerical data*
Arthroplasty, Replacement, Hip / statistics & numerical data
Arthroplasty, Replacement, Knee / statistics & numerical data
Cervical Vertebrae / pathology,  physiopathology,  surgery
Hip Joint / surgery
Humans
Outcome Assessment (Health Care) / methods*
Patient Satisfaction
Questionnaires*
Radiculopathy / surgery*
Range of Motion, Articular
Recovery of Function / physiology
Reproducibility of Results
Spinal Cord Compression / surgery*
Spinal Fusion / statistics & numerical data*
Treatment Outcome
Zygapophyseal Joint / pathology,  physiopathology,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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