Academic Journal
Efficacy and safety of surgical decompression in patients with cervical spondylotic myelopathy: results of the AOSpine North America prospective multi-center study.
| العنوان: | Efficacy and safety of surgical decompression in patients with cervical spondylotic myelopathy: results of the AOSpine North America prospective multi-center study. |
|---|---|
| المؤلفون: | Fehlings, Michael G, Wilson, Jefferson R, Kopjar, Branko, Yoon, Sangwook Tim, Arnold, Paul M, Massicotte, Eric M, Vaccaro, Alexander R, Brodke, Darrel S, Shaffrey, Christopher I, Smith, Justin S, Woodard, Eric J, Banco, Robert J, Chapman, Jens R, Janssen, Michael E, Bono, Christopher M, Sasso, Rick C, Dekutoski, Mark B, Gokaslan, Ziya L |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health) |
| سنة النشر: | 2023 |
| المجموعة: | Duke University Libraries: DukeSpace |
| مصطلحات موضوعية: | Cervical Vertebrae, Humans, Spinal Osteophytosis, Spinal Cord Diseases, Postoperative Complications, Magnetic Resonance Imaging, Disability Evaluation, Treatment Outcome, Decompression, Surgical, Severity of Illness Index, Follow-Up Studies, Prospective Studies, Quality of Life, Adult, Aged, Middle Aged, North America, Female, Male |
| الوصف: | Background Cervical spondylotic myelopathy is the leading cause of spinal cord dysfunction worldwide. The objective of this study was to evaluate the impact of surgical decompression on functional, quality-of-life, and disability outcomes at one year after surgery in a large cohort of patients with this condition. Methods Adult patients with symptomatic cervical spondylotic myelopathy and magnetic resonance imaging evidence of spinal cord compression were enrolled at twelve North American centers from 2005 to 2007. At enrollment, the myelopathy was categorized as mild (modified Japanese Orthopaedic Association [mJOA] score ≥ 15), moderate (mJOA = 12 to 14), or severe (mJOA < 12). Patients were followed prospectively for one year, at which point the outcomes of interest included the mJOA score, Nurick grade, Neck Disability Index (NDI), and Short Form-36 version 2 (SF-36v2). All outcomes at one year were compared with the preoperative values with use of univariate paired statistics. Outcomes were also compared among the severity classes with use of one-way analysis of variance. Finally, a multivariate analysis that adjusted for baseline differences among the severity groups was performed. Treatment-related complication data were collected and the overall complication rate was calculated. Results Eighty-five (30.6%) of the 278 enrolled patients had mild cervical spondylotic myelopathy, 110 (39.6%) had moderate disease, and 83 (29.9%) had severe disease preoperatively. One-year follow-up data were available for 222 (85.4%) of 260 patients. There was a significant improvement from baseline to one year postoperatively (p < 0.05) in the mJOA score, Nurick grade, NDI score, and all SF-36v2 health dimensions (including the mental and physical health composite scores) except general health. With the exception of the change in the mJOA, the degree of improvement did not depend on the severity of the preoperative symptoms. These results remained unchanged after adjusting for relevant confounders in the multivariate ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 0021-9355 1535-1386 |
| Relation: | The Journal of bone and joint surgery. American volume; 1734760; https://hdl.handle.net/10161/28822 |
| الاتاحة: | https://hdl.handle.net/10161/28822 |
| رقم الانضمام: | edsbas.E0B91692 |
| قاعدة البيانات: | BASE |
| تدمد: | 00219355 15351386 |
|---|