Surgery for degenerative cervical myelopathy in patients with rheumatoid arthritis and ankylosing spondylitis: a nationwide registry-based study with patient-reported outcomes

Holmberg, Siril T; Gulati, Agnete Malm; Johansen, Tonje; Salvesen, Øyvind; Vangen-Lønne, Vetle; Tronvik, Erling; Nygaard, Øystein P.; Gulati, Sasha

doi:10.1007/s00701-022-05382-9

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…T he available medical literature has shown that surgical procedures can improve functional status and quality of life by relieving spinal cord compression, especially in multilevel degenerative cervical myelopathy (MDCM). [1][2][3][4][5][6][7][8][9] Currently, anterior cervical spinal fusion surgery including anterior cervical discectomy fusion (ACDF) and anterior cervical corpectomy fusion (ACCF) are routinely used in patients with MDCM. Although ACDF can alleviate the compression by removing the disc and osteophyte directly.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Corpectomy ACDF Hybrid Procedures with Nano‐Hydroxyapatite/Polyamide 66 Cage and Titanium Mesh Cage for Multi‐level Degenerative Cervical Myelopathy: A Stepwise Propensity Score Matching Analysis

Li,

Hu,

Masood

et al. 2023

Orthopaedic Surgery

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ObjectivePrevious studies have found satisfactory clinical results with the nano‐hydroxyapatite/polyamide 66 (n‐HA/PA66) cage to reconstruct the stability of anterior cervical column. However, studies evaluating the long‐term outcomes of the n‐HA/PA66 cage in multi‐level degenerative cervical myelopathy (MDCM) have not been reported. This study aims to compare the outcomes of corpectomy anterior cervical discectomy and fusion (ACDF) hybrid procedures between the n‐HA/PA66 cage and titanium mesh cage (TMC) to treat MDCM.MethodsAfter the screening for eligibility, this retrospective study involved 90 patients who underwent corpectomy ACDF hybrid (CACDFH) procedure from June 2013 to June 2018. The CACDFH procedure is the combination of ACDF and anterior cervical corpectomy and fusion (ACCF). According to the cage utilized, we categorized patients into a n‐HA/PA66 cage group and a TMC group. Then, stepwise propensity score matching (PSM) was performed to maintain comparable clinical data between groups. All the patients were followed up ≥4 years and the longest follow‐up time was 65.43 (±11.49) months. Cage subsidence, adjacent segment degeneration (ASD), segmental height (SH), segmental angle (SA), cervical lordosis (CL), and clinical data (visual analogue scale [VAS] and Japanese Orthopaedic Association [JOA] score) was evaluated preoperatively, at 1 week, and at the final surgery follow‐up. The independent student's t test and chi‐square test were applied to compare the differences between groups.ResultsThrough PSM analysis, 25 patients from the n‐HA/PA66 group were matched to 25 patients in the TMC group. The occurrence of ASD was 16.0% (4/25) in the n‐HA/PA 66 group, which was significantly less than in the TMC group at 44.0% (11/25) (p = 0.031). Moreover, the cage subsidence rate was significantly higher in the TMC group as compared to the n‐HA/PA 66 group (40.0% vs. 12.0%, p = 0.024). But there was no significant difference in SH, SA, and CL at any time after surgery as determined through follow‐up. The VAS and JOA scores significantly improved in both groups at 3 months postoperative and at final follow‐up. However, there were no significant differences in the VAS and JOA score at any time between the two groups in preoperative (p > 0.05).ConclusionThe n‐HA/PA66 cage is associated with lower rate of cage subsidence and ASD than the TMC in the treatment of MDCM. The n‐HA/PA66 cage could be superior to the TMC in corpectomy ACDF hybrid procedures.

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Section: Introductionmentioning

confidence: 99%

A Comparison of Corpectomy ACDF Hybrid Procedures with Nano‐Hydroxyapatite/Polyamide 66 Cage and Titanium Mesh Cage for Multi‐level Degenerative Cervical Myelopathy: A Stepwise Propensity Score Matching Analysis

Li,

Hu,

Masood

et al. 2023

Orthopaedic Surgery

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Comparison of the patient-derived modified Japanese Orthopaedic Association scale and the European myelopathy score

de Dios,

Löfgren,

Laesser

et al. 2023

Eur Spine J

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Purpose To compare the patient-derived modified Japanese Orthopaedic Association (P-mJOA) scale with the European myelopathy score (EMS) for the assessment of patients with degenerative cervical myelopathy (DCM). Methods In this register-based cohort study with prospectively collected data, included patients were surgically treated for DCM and had reported both P-mJOA and EMS scores at baseline, 1-year follow-up, and/or 2-year follow-up to the Swedish Spine Register. P-mJOA and EMS scores were defined as severe (P-mJOA 0–11 and EMS 5–8), moderate (P-mJOA 12–14 and EMS 9–12), or mild (P-mJOA 15–18 and EMS 13–18). P-mJOA and EMS mean scores were compared, and agreement was evaluated with Spearman’s rank correlation coefficient (ρ), the intraclass correlation coefficient (ICC), and kappa (κ) statistics. Results Included patients (n = 714, mean age 63.2 years, 42.2% female) completed 937 pairs of the P-mJOA and the EMS. The mean P-mJOA and EMS scores were 13.9 ± 3.0 and 14.5 ± 2.7, respectively (mean difference –0.61 [95% CI –0.72 to –0.51; p < 0.001]). Spearman’s ρ was 0.84 (p < 0.001), and intra-rater agreement measured with ICC was 0.83 (p < 0.001). Agreement of severity level measured with unweighted and weighted κ was fair (κ = 0.22 [p < 0.001]; κ = 0.34 [p < 0.001], respectively). Severity levels were significantly higher using the P-mJOA (p < 0.001). Conclusion The P-mJOA and the EMS had similar mean scores, and intra-rater agreement was high, whereas severity levels only demonstrated fair agreement. The EMS has a lower sensitivity for detecting severe myelopathy but shows an increasing agreement with the P-mJOA for milder disease severity. A larger interval to define severe myelopathy with the EMS is recommended.

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Surgery for degenerative cervical myelopathy in patients with rheumatoid arthritis and ankylosing spondylitis: a nationwide registry-based study with patient-reported outcomes

Cited by 2 publications

References 22 publications

A Comparison of Corpectomy ACDF Hybrid Procedures with Nano‐Hydroxyapatite/Polyamide 66 Cage and Titanium Mesh Cage for Multi‐level Degenerative Cervical Myelopathy: A Stepwise Propensity Score Matching Analysis

A Comparison of Corpectomy ACDF Hybrid Procedures with Nano‐Hydroxyapatite/Polyamide 66 Cage and Titanium Mesh Cage for Multi‐level Degenerative Cervical Myelopathy: A Stepwise Propensity Score Matching Analysis

Comparison of the patient-derived modified Japanese Orthopaedic Association scale and the European myelopathy score

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