低い術前JOAスコア，高齢および長い罹病期間は頚椎拡大術の成績を悪くする

Lower Preoperative JOA Score, Higher Age, and Longer Duration of Symptoms Prior to Surgery Are Associated with a Poorer Outcomes of Laminoplasty for Cervical Myelopathy

　頚部脊髄症に対し片開き式脊柱管拡大術を行った247例を対象として，年齢，罹病期間，術前重症度と術後成績との関連を調査した．年齢と術前JOAスコア，術後JOAスコア，ならびに改善率は有意に負の相関を示した．罹病期間と改善率は有意に負の相関を示した．術前JOAスコアと術後JOAスコアは強い正の相関を示した．年齢，罹病期間および術前JOAスコアから，術後JOAスコアを予測するのに役立つ回帰関数が得られた．術後の患者のQOLをより高くするためには，症状の悪化を看過せず，手術に踏み切ることが重要である．

　The relationship between age, preoperative morbidity, and duration of symptoms prior to surgery and the surgical outcomes of open-door laminoplasty was investigated in 247 patients with cervical myelopathy. Age was significantly negatively correlated with pre-and post-operative JOA scores and recovery rate. The duration of symptoms prior to surgery was negatively correlated with the recovery rate. The preoperative JOA scores were strongly correlated with the postoperative JOA scores. A multiple regression analysis that included data on age, duration of symptoms prior to surgery, and the preoperative JOA score generated a regression equation that could predict the postoperative JOA score. Lower preoperative JOA score, higher age, and longer duration of symptoms prior to surgery were associated with poor outcomes of laminoplasty. To maintain postoperative patients' QOL, surgery should not be delayed.