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Surgery for Degenerative Cervical Myelopathy: A Nationwide Registry-Based Observational Study With Patient-Reported Outcomes
BACKGROUND: Indications and optimal timing for surgical treatment of degenerative cervical myelopathy (DCM) remain unclear, and data from daily clinical practice are warranted. OBJECTIVE: To investigate clinical outcomes following decompressive surgery for DCM. METHODS: Data were obtained from the N...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453385/ https://www.ncbi.nlm.nih.gov/pubmed/34325471 http://dx.doi.org/10.1093/neuros/nyab259 |
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author | Gulati, Sasha Vangen-Lønne, Vetle Nygaard, Øystein P Gulati, Agnete M Hammer, Tommy A Johansen, Tonje O Peul, Wilco C Salvesen, Øyvind O Solberg, Tore K |
author_facet | Gulati, Sasha Vangen-Lønne, Vetle Nygaard, Øystein P Gulati, Agnete M Hammer, Tommy A Johansen, Tonje O Peul, Wilco C Salvesen, Øyvind O Solberg, Tore K |
author_sort | Gulati, Sasha |
collection | PubMed |
description | BACKGROUND: Indications and optimal timing for surgical treatment of degenerative cervical myelopathy (DCM) remain unclear, and data from daily clinical practice are warranted. OBJECTIVE: To investigate clinical outcomes following decompressive surgery for DCM. METHODS: Data were obtained from the Norwegian Registry for Spine Surgery. The primary outcome was change in the neck disability index (NDI) 1 yr after surgery. Secondary endpoints were the European myelopathy score (EMS), quality of life (EuroQoL 5D [EQ-5D]), numeric rating scales (NRS) for headache, neck pain, and arm pain, complications, and perceived benefit of surgery assessed by the Global Perceived Effect (GPE) scale. RESULTS: We included 905 patients operated between January 2012 and June 2018. There were significant improvements in all patient-reported outcome measures (PROMs) including NDI (mean −10.0, 95% CI −11.5 to −8.4, P < .001), EMS (mean 1.0, 95% CI 0.8-1.1, P < .001), EQ-5D index score (mean 0.16, 95% CI 0.13-0.19, P < .001), EQ-5D visual analogue scale (mean 13.8, 95% CI 11.7-15.9, P < .001), headache NRS (mean −1.1, 95% CI −1.4 to −0.8, P < .001), neck pain NRS (mean −1.8, 95% CI −2.0 to −1.5, P < .001), and arm pain NRS (mean −1.7, 95% CI −1.9 to −1.4, P < .001). According to GPE scale assessments, 229/513 patients (44.6%) experienced “complete recovery” or felt “much better” at 1 yr. There were significant improvements in all PROMs for both mild and moderate-to-severe DCM. A total of 251 patients (27.7%) experienced adverse effects within 3 mo. CONCLUSION: Surgery for DCM is associated with significant and clinically meaningful improvement across a wide range of PROMs. |
format | Online Article Text |
id | pubmed-8453385 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-84533852021-09-22 Surgery for Degenerative Cervical Myelopathy: A Nationwide Registry-Based Observational Study With Patient-Reported Outcomes Gulati, Sasha Vangen-Lønne, Vetle Nygaard, Øystein P Gulati, Agnete M Hammer, Tommy A Johansen, Tonje O Peul, Wilco C Salvesen, Øyvind O Solberg, Tore K Neurosurgery Research—Human—Clinical Studies BACKGROUND: Indications and optimal timing for surgical treatment of degenerative cervical myelopathy (DCM) remain unclear, and data from daily clinical practice are warranted. OBJECTIVE: To investigate clinical outcomes following decompressive surgery for DCM. METHODS: Data were obtained from the Norwegian Registry for Spine Surgery. The primary outcome was change in the neck disability index (NDI) 1 yr after surgery. Secondary endpoints were the European myelopathy score (EMS), quality of life (EuroQoL 5D [EQ-5D]), numeric rating scales (NRS) for headache, neck pain, and arm pain, complications, and perceived benefit of surgery assessed by the Global Perceived Effect (GPE) scale. RESULTS: We included 905 patients operated between January 2012 and June 2018. There were significant improvements in all patient-reported outcome measures (PROMs) including NDI (mean −10.0, 95% CI −11.5 to −8.4, P < .001), EMS (mean 1.0, 95% CI 0.8-1.1, P < .001), EQ-5D index score (mean 0.16, 95% CI 0.13-0.19, P < .001), EQ-5D visual analogue scale (mean 13.8, 95% CI 11.7-15.9, P < .001), headache NRS (mean −1.1, 95% CI −1.4 to −0.8, P < .001), neck pain NRS (mean −1.8, 95% CI −2.0 to −1.5, P < .001), and arm pain NRS (mean −1.7, 95% CI −1.9 to −1.4, P < .001). According to GPE scale assessments, 229/513 patients (44.6%) experienced “complete recovery” or felt “much better” at 1 yr. There were significant improvements in all PROMs for both mild and moderate-to-severe DCM. A total of 251 patients (27.7%) experienced adverse effects within 3 mo. CONCLUSION: Surgery for DCM is associated with significant and clinically meaningful improvement across a wide range of PROMs. Oxford University Press 2021-07-29 /pmc/articles/PMC8453385/ /pubmed/34325471 http://dx.doi.org/10.1093/neuros/nyab259 Text en © Congress of Neurological Surgeons 2021. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Research—Human—Clinical Studies Gulati, Sasha Vangen-Lønne, Vetle Nygaard, Øystein P Gulati, Agnete M Hammer, Tommy A Johansen, Tonje O Peul, Wilco C Salvesen, Øyvind O Solberg, Tore K Surgery for Degenerative Cervical Myelopathy: A Nationwide Registry-Based Observational Study With Patient-Reported Outcomes |
title | Surgery for Degenerative Cervical Myelopathy: A Nationwide Registry-Based Observational Study With Patient-Reported Outcomes |
title_full | Surgery for Degenerative Cervical Myelopathy: A Nationwide Registry-Based Observational Study With Patient-Reported Outcomes |
title_fullStr | Surgery for Degenerative Cervical Myelopathy: A Nationwide Registry-Based Observational Study With Patient-Reported Outcomes |
title_full_unstemmed | Surgery for Degenerative Cervical Myelopathy: A Nationwide Registry-Based Observational Study With Patient-Reported Outcomes |
title_short | Surgery for Degenerative Cervical Myelopathy: A Nationwide Registry-Based Observational Study With Patient-Reported Outcomes |
title_sort | surgery for degenerative cervical myelopathy: a nationwide registry-based observational study with patient-reported outcomes |
topic | Research—Human—Clinical Studies |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453385/ https://www.ncbi.nlm.nih.gov/pubmed/34325471 http://dx.doi.org/10.1093/neuros/nyab259 |
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