高齢者（75歳以上）重症頚髄症の術後評価―患者立脚型アウトカム評価の有用性

Quality of Life in Elderly Patients with Severe Cervical Spondylotic Myelopathy

　75歳以上の高齢者重症頚髄症の術後評価を患者立脚型アウトカムを中心に検討した．対象は1994～2003年までに手術を行ったJOAスコア10点以下の19例で，これらに対しJOAスコア，患者・家族の満足度，生活自立度，さらにSF-36^®によるQOL評価を行った．JOAスコアの改善率は21.5％と低く，満足度とは相関していなかった．満足度は生活自立するほど高く，またSF-36^®の精神健康面の評価と強く相関していた．以上より高齢者重症頚髄症の術後評価には生活自立度や健康関連QOL評価が重要である．

　This study explored the outcome of elderly patients (＞75 years) with severe cervical spondylotic myelopathy. The disease-specific status and patient-based outcome of 19 patients who received cervical spine surgeries between 1994 and 2003 were evaluated. The postoperative recovery rate, determined by comparing the JOA scores, was only 21.5％ and was poorly correlated with the patient or family's level of satisfaction with the surgical results. On the other hand, patient or family satisfaction was strongly correlated with the mental component domains of the SF-36^®, a generic health QOL status, and was also correlated with the patients' levels of independence. Therefore, generic QOL assessments and nursing care conditions should be considered when reporting the outcomes of cervical spondylotic myelopathy, especially in elderly people.