At the 1-year follow-up, researchers who performed surgical
decompression in patients with cervical spondylotic myelopathy found
significantly improved disability-related, functional and
quality-of-life outcomes, according to a study recently published in Journal of Bone & Joint Surgery.
“The results of this trial support the use of decompression surgery
as a viable treatment for cervical spondylotic myelopathy and could lead
to a change in practice to treat this condition,” neurosurgeon Michael G. Fehlings,
who is medical director of the Krembil Neuroscience Centre at Toronto
Western Hospital, stated in a press release. “With few existing
interventions available for these patients, it is encouraging to have
data showing improvements in quality of life as a result of surgery, in
some cases, even reversing serious neurological damage that could have
resulted in paralysis.”
Fehlings and colleagues analyzed results from a trial with 278
patients who had mild, moderate or severe cervical spondylotic
myelopathy (CSM) conducted between 2005 and 2007 at 12 centers in the
United States and Canada. Of the patients enrolled, 222 patients had
1-year follow-up data available.
The researchers found improved modified Japanese Orthopaedic
Association, Neck Disability Index, SF-36 version 2 and Nurick grade
scores in all patients between baseline and 1-year postoperative,
according to the abstract. The rate of improvement did not depend upon
preoperative CSM severity, and after a multivariate analysis, the
results were unchanged when they adjusted for confounders.
“Although all patients experienced improvement in their condition
after surgery, the challenge now is to ensure patients suffering from
CSM receive surgical intervention in the earlier stages of the disease,”
Fehlings said. “This approach ensures patients avoid permanent
neurological impairment, and will reduce costs to the healthcare system
over the long term.”
Reference:
Fehlings MG. J Bone Joint Surg Am. 2013;doi:10.2106/JBJS.L.00589.
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