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EuroQol-5 dimensions health-related quality of life questionnaire in craniovertebral instability treated with posterior fixation with or without occipital plating: A comparative study with matched datasets

EuroQol-5 dimensions health-related quality of life questionnaire in craniovertebral instability treated with posterior fixation with or without occipital plating: A comparative study with matched datasets

Tomasz Klepinowski  1 , Leszek Sagan  1
Affiliations

Free PMC article

Abstract

Objective: Health-related quality of life (HRQoL) in craniocervical instability (CCI) before and after posterior fixation is yet to be determined. This study aimed to deliver novel and clinically relevant data about HRQoL (baseline, at follow-up, predictors, and correlates) in subjects with CCI treated with posterior fixation with or without occipital plating, and to compare it with matched datasets.

Methods: EuroQol-5 dimensions (EQ-5D) questionnaires were collected to evaluate HRQoL before surgery and at follow-up. Study sample size was estimated at 58. Comparison with representative datasets was done by matching on a many-to-many basis. Classic CCI parameters were measured. Strengthening the Reporting of Observational Studies in Epidemiology was followed.

Results: Sixty subjects were included. The mean age was 37.2 years. The median follow-up for EQ-5D was 26.3 months with interquartile range (IQR) 10.8 to 47.3 months. The median preoperative score of the 3-level version of EQ-5D (EQ-5D-3L) was 0.254 (IQR = -0.025 to 0.504), whereas at follow-up, it increased to 0.779 (IQR = 0.387-0.864) which is still worse than the 25th percentile (0.894) of the age-matched population. Occipital plating (n = 35; 58.3%) did not influence HRQoL trajectory (P = 0.692). In multiple linear regression, HRQoL at follow-up was affected by the age (β = -0.004; P = 0.049) and length of hospitalization (β = -0.134; P = 0.010). Of radiologic measurements, preoperative Wackenheim line correlated with HRQoL at follow-up (rho = -0.432; P = 0 – 028).

Conclusions: HRQoL is significantly reduced in CCI. Although this can be improved with posterior fixation, it is still worse than the age-matched population. Occipital plating may not influence HRQoL. HRQoL of the elderly might not increase as much as of the younger subjects. The longer hospitalization, the worse HRQoL could be expected. Preoperative Wackenheim parameter could correlate with HRQoL at follow-up.

Keywords: Atlantoaxial fusion; EuroQol-5 dimensions-3L; atlantooccipital fusion; craniocervical fixation; health-related quality of life; occipital plating.

Conflict of interest statement

There are no conflicts of interest.

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References

    1. Phuntsok R, Ellis BJ, Herron MR, Provost CW, Dailey AT, Brockmeyer DL. The occipitoatlantal capsular ligaments are the primary stabilizers of the occipitoatlantal joint in the craniocervical junction: A finite element analysis. J Neurosurg Spine. 2019;30:593–601. – PubMed
    1. Klepinowski T, Cembik J, Sagan L. Risk of the high-riding variant of vertebral arteries at C2 is increased over twofold in rheumatoid arthritis: A meta-analysis. Neurosurg Rev. 2021;44:2041–6. – PMC – PubMed
    1. Klepinowski T, Limanówka B, Sagan L. Management of post-traumatic craniovertebral junction dislocation: A PRISMA-compliant systematic review and meta-analysis of casereports. Neurosurg Rev. 2021;44:1391–400. – PMC – PubMed
    1. Slobodin G, Shpigelman A, Dawood H, Rimar D, Croitoru S, Boulman N, et al. Craniocervical junction involvement in ankylosing spondylitis. Eur Spine J. 2015;24:2986–90. – PubMed
    1. Harms J, Melcher RP. Posterior C1-C2 fusion with polyaxial screw and rod fixation. Spine (Phila Pa 1976) 2001;26:2467–71. – PubMed
    1. Goel A, Laheri V. Plate and screw fixation for atlanto-axial subluxation. Acta Neurochir (Wien) 1994;129:47–53. – PubMed
    1. Vedantam A, Hansen D, Briceño V, Brayton A, Jea A. Patient-reported outcomes of occipitocervical and atlantoaxial fusions in children. J Neurosurg Pediatr. 2017;19:85–90. – PubMed
    1. Mendenhall SK, Sivaganesan A, Mistry A, Sivasubramaniam P, McGirt MJ, Devin CJ. Traumatic atlantooccipital dislocation: Comprehensive assessment of mortality, neurologic improvement, and patient-reported outcomes at a Level 1 trauma center over 15 years. Spine J. 2015;15:2385–95. – PubMed
    1. Goel A. Is inclusion of the occipital bone necessary/counter-effective for craniovertebral junction stabilization? J Craniovertebr Junction Spine. 2015;6:102–4. – PMC – PubMed
    1. Schwab JH, Janssen SJ, Paulino Pereira NR, Chen YL, Wain JC, DeLaney TF, et al. Quality of life after resection of a chordoma of the mobile spine. Bone Joint J. 2017;99-B:979–86. – PubMed
    1. Xiao R, Miller JA, Abdullah KG, Lubelski D, Mroz TE, Benzel EC. Quality of life outcomes following resection of adult intramedullary spinal cord tumors. Neurosurgery. 2016;78:821–8. – PubMed
    1. Golicki D, Jakubczyk M, Niewada M, Wrona W, Busschbach JJ. Valuation of EQ-5D health states in Poland: First TTO-based social value set in Central and Eastern Europe. Value Health. 2010;13:289–97. – PubMed
    1. Golicki D, Niewada M. General population reference values for 3-level EQ-5D (EQ-5D-3L) questionnaire in Poland. Pol Arch Med Wewn. 2015;125:18–26. – PubMed
    1. Joaquim AF, Osorio JA, Riew KD. Occipitocervical fixation: General considerations and surgical technique. Global Spine J. 2020;10:647–56. – PMC – PubMed
    1. Goel A. Facetal alignment: Basis of an alternative Goel’s classification of basilar invagination. J Craniovertebr Junction Spine. 2014;5:59–64. – PMC – PubMed
    1. Joelson A, Sigmundsson FG, Karlsson J. Properties of the EQ-5D-3L index distribution when longitudinal data from 27,328 spine surgery procedures are applied to nine national EQ-5D-3L value sets. Qual Life Res. 2021;30:1467–75. – PubMed
    1. McDonough CM, Grove MR, Tosteson TD, Lurie JD, Hilibrand AS, Tosteson AN. Comparison of EQ-5D, HUI, and SF-36-derived societal health state values among spine patient outcomes research trial (SPORT) participants. Qual Life Res. 2005;14:1321–32. – PMC – PubMed
    1. Kanodia G, Parihar V, Yadav YR, Bhatele PR, Sharma D. Morphometric analysis of posterior fossa and foramen magnum. J Neurosci Rural Pract. 2012;3:261–6. – PMC – PubMed
    1. Pawar KA, Mishra AS, Bandagi G, Srivastava SK. Roentgenographic and computerized tomography based morphometric analysis of cervical spinal canal diameters to establish normative measurements in an Indian population. J Clin Orthop Trauma. 2017;8:185–90. – PMC – PubMed
    1. Ulbrich EJ, Schraner C, Boesch C, Hodler J, Busato A, Anderson SE, et al. Normative MR cervical spinal canal dimensions. Radiology. 2014;271:172–82. – PubMed
    1. Dahdaleh NS, Khanna R, Menezes AH, Smith ZA, Viljoen SV, Koski TR, et al. The application of the revised condyle-C1 interval method to diagnose traumatic atlanto-occipital dissociation in adults. Global Spine J. 2016;6:529–34. – PMC – PubMed
    1. Marathe NA, Dahapute AA, Desai JR, Dhole KP, Bhaladhare S, Shah S. X-ray and computed tomography scan-based morphometric analysis of skull baselines in Indian population. Asian J Neurosurg. 2019;14:1116–21. – PMC – PubMed
    1. Klepinowski T, Pala B, Cembik J, Sagan L. Prevalence of high-riding vertebral artery: A meta-analysis of the anatomical variant affecting choice of craniocervical fusion method and its outcome. World Neurosurg. 2020;143:e474–81. – PubMed
    1. Klepinowski T, Żyłka N, Pala B, Poncyljusz W, Sagan L. Prevalence of high-riding vertebral arteries and narrow C2 pedicles among Central-European population: A computed tomography-based study. Neurosurg Rev. 2021;44:3277–82. – PMC – PubMed
    1. Coretti S, Ruggeri M, McNamee P. The minimum clinically important difference for EQ-5D index: A critical review. Expert Rev Pharmacoecon Outcomes Res. 2014;14:221–33. – PubMed
    1. Koga R, Sasaki T, Ideta R, Iwahashi K, Tsugami C, Nishimura A, et al. The EQ-5D-5L in patients admitted to a hospital in Japan with recent spinal cord injury: A descriptive study. Spinal Cord. 2019;57:960–5. – PubMed
    1. Hurst NP, Kind P, Ruta D, Hunter M, Stubbings A. Measuring health-related quality of life in rheumatoid arthritis: Validity, responsiveness and reliability of EuroQol (EQ-5D) Br J Rheumatol. 1997;36:551–9. – PubMed
    1. Bond MR, Versteeg AL, Sahgal A, Rhines LD, Sciubba DM, Schuster JM, et al. Surgical or radiation therapy for the treatment of cervical spine metastases: Results from the epidemiology, process, and outcomes of spine oncology (EPOSO) cohort. Global Spine J. 2020;10:21–9. – PMC – PubMed
    1. Smith JS, Line B, Bess S, Shaffrey CI, Kim HJ, Mundis G, et al. The health impact of adult cervical deformity in patients presenting for surgical treatment: Comparison to United States population norms and chronic disease states based on the EuroQuol-5 Dimensions Questionnaire. Neurosurgery. 2017;80:716–25. – PubMed
    1. Svedbom A, Borgström F, Hernlund E, Ström O, Alekna V, Bianchi ML, et al. Quality of life after hip, vertebral, and distal forearm fragility fractures measured using the EQ-5D-3L, EQ-VAS, and time-trade-off: Results from the ICUROS. Qual Life Res. 2018;27:707–16. – PubMed
    1. Na L, Streim JE. Psychosocial well-being associated with activity of daily living stages among community-dwelling older adults. Gerontol Geriatr Med. 2017;3:1–13. – PMC – PubMed
    1. Kwong Y, Rao N, Latief K. Craniometric measurements in the assessment of craniovertebral settling: Are they still relevant in the age of cross-sectional imaging? AJR Am J Roentgenol. 2011;196:W421–5. – PubMed
    1. Salunke P, Sahoo SK. Irreducible posterior C1-2 dislocation with retrolisthesis of dens: Hindsight from 10 cases. World Neurosurg. 2019;123:e202–10. – PubMed
    1. Goel A. Craniovertebral junction instability: A review of facts about facets. Asian Spine J. 2015;9:636–44. – PMC – PubMed

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