[Correlation of pre-operative factors with the outcome of surgical treatment of Hirayama disease].

OBJECTIVE

To investigate the relationship of pre-operative clinical related factors with the outcome of surgical treatment in patients with Hirayama disease.

METHODS

A total of 46 consecutive patients with Hirayama disease treated by anterior cervical discectomy decompression and fusion in Peking University Third Hospital from October 2006 to January 2014 were reviewed retrospectively. Odom's criteria was used to evaluate the subjective outcome of surgical treatment. Five pre-operative factors were collected including duration of disease at the time of treatment, age of onset, extremity involvement, gross hand function score and fine hand function score. The correlation between these five clinical related factors and postoperative outcome was evaluated with Logistic regression. The receiver operating characteristic (ROC) curve and area under the ROC curve were used to evaluate the significant result of Logistic regression and the optimal diagnostic value.

RESULTS

A total of 40 in 46 (87.0%) patients with complete clinical and radiographic follow-up data were included in this study. The mean follow-up period was 48.6 months (12-98 months). All patients were male. The outcome at the final follow-up according to Odom's criteria was: Excellent 5 cases, Good 21 cases, Fair 14 cases and no Poor case. Only two pre-operative factors, age of onset and gross hand function score, showed statistical correlation with the post-operative outcome assessment by Logistic regression. ROC analysis showed that the area under the ROC curve of age of onset and gross hand function score were 0.790 and 0.793 respectively. The optimal predictive threshold was 15.5 years old and 5.5 points respectively.

CONCLUSIONS

Age of onset and gross hand function score were two pre-operative factors correlated with the post-operative outcome. These two factors could be used to predict the outcome of surgical treatment of Hirayama disease preoperatively.