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Correlation of mJOA, PROMIS physical function, and patient satisfaction in patients with cervical myelopathy: an

Mathieu Squires1, Lonni Schultz2, Jason Schwalb2

  • 1Department of Orthopedic Surgery, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109, USA.

The Spine Journal : Official Journal of the North American Spine Society
|December 25, 2022
PubMed
Abstract

Insights

Patient-reported outcomes for cervical myelopathy surgery show Patient-Reported Outcomes Measurement Information System (PROMIS) physical function (PF) strongly correlates with the modified Japanese Orthopaedic Association (mJOA) scale. Both PROMIS PF and mJOA predict patient satisfaction similarly two years post-surgery.

Area of Science:

  • Spine surgery outcomes research
  • Orthopedics
  • Patient-reported outcome measures

Background:

  • Patient-reported outcomes (PROs) are crucial for evaluating spinal procedure efficacy.
  • The modified Japanese Orthopaedic Association (mJOA) scale is standard for cervical myelopathy, alongside PROMIS physical function (PF) and patient satisfaction.
  • Direct comparison of these outcomes at 2 years post-surgery in a large registry was lacking.

Purpose of the Study:

  • To determine the correlation and association between PROMIS PF, mJOA, and patient satisfaction in cervical myelopathy surgery patients.
  • To compare the utility of PROMIS PF and mJOA in assessing surgical outcomes for cervical myelopathy.

Main Methods:

  • Retrospective analysis of a multicenter spine registry (MSSIC database).
  • Included 2,023 adult patients with cervical myelopathy undergoing surgery between 2018 and 2021.
  • Quantified correlations between mJOA and PROMIS PF using Spearman's coefficients up to 2 years postoperatively; assessed agreement and association with patient satisfaction using Kappa statistics and odds ratios.

Main Results:

  • Moderate to strong correlations (p<.001) were observed between mJOA and PROMIS PF at all time points.
  • Fair agreement was found when comparing those reaching the minimum clinically important difference (MCID) for both instruments.
  • Patient satisfaction was strongly related to changes in both mJOA and PROMIS PF (p<.001); PROMIS PF showed higher odds of associating with satisfaction MCID.

Conclusions:

  • PROMIS PF demonstrates strong positive correlation with mJOA in cervical myelopathy surgery patients up to 2 years postoperatively.
  • Both PROMIS PF and mJOA similarly predict patient satisfaction at 2 years.
  • PROMIS PF is a valid and potentially more practical outcome measure for clinical use due to its generalizability and ease of use.
Keywords:
CervicalMyelopathyOutcomesPROMISSatisfactionSpinemJOA

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