Pattern and Rate of Functional Recovery After Surgery for Cervical Spondylotic Myelopathy: Egyptian Prospective Study

Elbhrawy, Sonia; Abdou, Ashraf A; Elsaghir, Hesham; Ashram, Yasmine A.; Mekky, Jaidaa

doi:10.1016/j.wneu.2021.02.130

Cited by 3 publications

(2 citation statements)

References 36 publications

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“…The small improvement in bladder dysfunction for a small number of patients is also in accordance with the literature as few patients regain this control after surgery [3]. A prospective study of 25 patients reported only one out of seven patients (14.2%) with improved sphincter dysfunction post surgery [16]. The prospective nature and accurate data collection is a strength of this study; however, the sample size is very small.…”

Section: Number Of Patient-reported Pre-surgery Symptoms and Bladder ...supporting

confidence: 80%

“…Two scoring methods were used to assess functional and neurological outcomes. The mJOA score ranges from 0-18, 18 is no loss of function, mild (15)(16)(17), moderate (12)(13)(14), severe (0-11) DCM, and considers sensory and motor functional deficits and loss of bladder and bowel control. The MRC scoring system grades strength in the upper limbs and lower limbs out of 5 (0/5 = no power and 5/5 = normal power).…”

Section: Definitions and Data Variablesmentioning

confidence: 99%

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A Retrospective Study of Degenerative Cervical Myelopathy and the Surgical Management Within Northern Ireland

Saunders,

Sandhu,

McBride

et al. 2023

Cureus

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Introduction: Degenerative cervical myelopathy (DCM) is a condition of growing concern due to its increasing incidence among the ageing population. It involves age-associated pathological changes of the cervical spine that can result in spinal cord compression. This can lead to deficits in motor and sensory function of the upper and lower limbs, issues with balance and dexterity, as well as bladder and bowel disturbance. Patients can be categorised as having mild, moderate, or severe degenerative cervical myelopathy depending on their modified Japanese Orthopaedic Association (mJOA) score. This condition is generally managed surgically; however, patients with mild degenerative cervical myelopathy may be offered or opt for non-surgical treatment initially.Aims: The main aim of this study is to evaluate the surgical management of patients with DCM and to ascertain the degree of mJOA improvement from pre-surgery and one-year post-surgery follow-up. The second aim of the study is to explore the demographics within Northern Ireland who are diagnosed with DCM and who undergo surgery. This information could allow for better planning of services in the future for this patient cohort.Methods: This is a retrospective review of the surgical management of degenerative cervical myelopathy within the Regional Spinal Orthopaedic Unit in Northern Ireland over three years with one-year follow-up. The data was retrospectively collected from the Fracture Outcome Research Database. A total of 102 patients (10:7, male:female) with DCM were retrospectively evaluated. Exclusion criteria included all patients diagnosed with spinal tumour, fracture, central cord syndrome, and dislocation. Two patients were removed due to incorrect coding of DCM diagnosis and were not included. Key variables assessed were gender, age, symptoms, type of surgery, complications, and MRC score and mJOA score pre-surgery, 48 hours, six months, and one year post surgery. The choice of surgery was guided by the maximal angle of compression, the number of vertebral levels involved, patient comorbidities, and anesthetic risk.Results: The sample consisted of 60 men (58.82%) and 42 women (41.17%) with an average age of 57.17 ± 12.13 years ranging from 27 to 83 years old. Statistical analysis was conducted to explore the effect of time before and after surgery up to one year on the mJOA score. There was a significant difference in mJOA score pre-surgery and at six months and one year post surgery (R = 0.579053, p <0.001). Of the patients, 61.8% with a length of stay greater than three days and 71.4% of patients with a length of stay greater than seven days had a posterior approach surgery. A multiple linear regression analysis revealed that the mJOA score pre-surgery and the presence of complications significantly predicted the length of stay post-surgery (β -1.044, p = .011 and β -5.791, p = .028). Conclusion:The first key finding of this study is that the mJOA score tends to improve after surgery for the majority of patients, particularly at six months, which is co...

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Section: Number Of Patient-reported Pre-surgery Symptoms and Bladder ...supporting

confidence: 80%

Section: Definitions and Data Variablesmentioning

confidence: 99%

A Retrospective Study of Degenerative Cervical Myelopathy and the Surgical Management Within Northern Ireland

Saunders,

Sandhu,

McBride

et al. 2023

Cureus

View full text Add to dashboard Cite

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Predicting postoperative recovery in cervical spondylotic myelopathy: construction and interpretation of T2*-weighted radiomic-based extra trees models

et al. 2022

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Recovery Trajectories of Patient-reported Outcomes After Surgery for Degenerative Cervical Myelopathy

Banerjee,

Yang,

Wang

et al. 2024

Clinical Spine Surgery

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Study Design: Retrospective study. Objective: The aim of this study was to identify recovery trajectory clusters after surgery for degenerative cervical myelopathy (DCM), as well as to determine clinical and imaging characteristics associated with functional recovery trajectories. Background: Accurate prediction of postsurgical neurological recovery for the individual patient with DCM is challenging due to varying patterns of functional recovery. Latent class Bayesian models can model individual patient patterns and identify groups of patients with similar phenotypes for personalized prognostication. Methods: A prospective single-center study of 70 consecutive patients with DCM undergoing elective cervical spine decompression for DCM between 2010 and 2017 was performed. Outcomes were recorded using the modified Japanese Orthopedic Association (mJOA), Neck Disability Index (NDI), and the Short Form–36 Physical Component Score (SF-36 PCS) at 3, 6, 12, and 24 months. Recovery trajectories were constructed based on unsupervised Bayesian latent class modeling. Clinical and imaging predictors of recovery trajectories were also determined. Results: Recovery after surgery for DCM showed 3 distinct recovery trajectory clusters for each outcome. The commonest recovery trajectory was sustained improvement for the mJOA (41.1%), stagnation for the NDI (60.3%), and stability for the SF-36 PCS (46.6%). Age, duration of symptoms, and baseline disability were the strongest predictors of each recovery trajectory. Degree of cord compression, neck pain, and intramedullary T2-hyperintensity were predictive of NDI and SF-36 PCS but not mJOA recovery trajectory. Sex was associated with the NDI recovery trajectory but not SF-36 PCS and mJOA recovery trajectories. Conclusion: Using prospective data and a data-driven approach, we identified 3 distinct recovery trajectory clusters and associated factors for mJOA, NDI, and SF-36 PCS in the first 24 months after surgery for DCM. Our results can enhance personalized clinical prognostication and guide patient expectations at different time points after surgery for DCM.

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Pattern and Rate of Functional Recovery After Surgery for Cervical Spondylotic Myelopathy: Egyptian Prospective Study

Cited by 3 publications

References 36 publications

A Retrospective Study of Degenerative Cervical Myelopathy and the Surgical Management Within Northern Ireland

A Retrospective Study of Degenerative Cervical Myelopathy and the Surgical Management Within Northern Ireland

Predicting postoperative recovery in cervical spondylotic myelopathy: construction and interpretation of T2*-weighted radiomic-based extra trees models

Recovery Trajectories of Patient-reported Outcomes After Surgery for Degenerative Cervical Myelopathy

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