Long-Term Results After Surgery for Degenerative Cervical Myelopathy
BACKGROUND AND OBJECTIVES: Degenerative cervical myelopathy (DCM) is a frequent cause of spinal cord dysfunction, and surgical treatment is considered safe and effective. Long-term results after surgery are limited. This study investigated long-term clinical outcomes through data from the Norwegian...
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Ovid Technologies (Wolters Kluwer Health)
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Online Access: | http://dx.doi.org/10.1227/neu.0000000000002712 https://journals.lww.com/10.1227/neu.0000000000002712 |
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crovidcr:10.1227/neu.0000000000002712 2024-03-24T09:04:07+00:00 Long-Term Results After Surgery for Degenerative Cervical Myelopathy Johansen, Tonje O. Holmberg, Siril T. Danielsen, Elisabet Rao, Vidar Salvesen, Øyvind O. Andresen, Hege Carmen, Vleggeert-Lankamp L. A. Solberg, Tore K. Gulati, Sasha Nygaard, Øystein P. 2023 http://dx.doi.org/10.1227/neu.0000000000002712 https://journals.lww.com/10.1227/neu.0000000000002712 en eng Ovid Technologies (Wolters Kluwer Health) http://creativecommons.org/licenses/by-nc-nd/4.0/ Neurosurgery volume 94, issue 3, page 454-460 ISSN 0148-396X 1524-4040 Neurology (clinical) Surgery journal-article 2023 crovidcr https://doi.org/10.1227/neu.0000000000002712 2024-02-28T00:17:59Z BACKGROUND AND OBJECTIVES: Degenerative cervical myelopathy (DCM) is a frequent cause of spinal cord dysfunction, and surgical treatment is considered safe and effective. Long-term results after surgery are limited. This study investigated long-term clinical outcomes through data from the Norwegian registry for spine surgery. METHODS: Patients operated at the university hospitals serving Central and Northern Norway were approached for long-term follow-up after 3 to 8 years. The primary outcome was change in the Neck Disability Index, and the secondary outcomes were changes in the European Myelopathy Scale score, quality of life (EuroQoL EQ-5D); numeric rating scales (NRS) for headache, neck pain, and arm pain; and perceived benefit of surgery assessed by the Global Perceived Effect scale from 1 year to long-term follow-up. RESULTS: We included 144 patients operated between January 2013 and June 2018. In total, 123 participants (85.4%) provided patient-reported outcome measures (PROMs) at long-term follow-up. There was no significant change in PROMs from 1 year to long-term follow-up, including Neck Disability Index (mean 1.0, 95% CI −2.1-4.1, P = .53), European Myelopathy Scale score (mean −0.3, 95% CI −0.7-0.1, P = .09), EQ-5D index score (mean −0.02, 95% CI −0.09-0.05, P = .51), NRS neck pain (mean 0.3 95% CI −0.2-0.9, P = .22), NRS arm pain (mean −0.1, 95% CI −0.8-0.5, P = .70), and NRS headache (mean 0.4, 95% CI −0.1-0.9, P = .11). According to Global Perceived Effect assessments, 106/121 patients (87.6%) reported to be stable or improved (“complete recovery,” “much better,” “slightly better,” or “unchanged”) at long-term follow-up compared with 88.1% at 1 year. Dichotomizing the outcome data based on severity of DCM did not demonstrate significant changes either. CONCLUSION: Long-term follow-up of patients undergoing surgery for DCM demonstrates persistence of statistically significant and clinically meaningful improvement across a wide range of PROMs. Article in Journal/Newspaper Northern Norway Ovid Norway Neurosurgery |
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language |
English |
topic |
Neurology (clinical) Surgery |
spellingShingle |
Neurology (clinical) Surgery Johansen, Tonje O. Holmberg, Siril T. Danielsen, Elisabet Rao, Vidar Salvesen, Øyvind O. Andresen, Hege Carmen, Vleggeert-Lankamp L. A. Solberg, Tore K. Gulati, Sasha Nygaard, Øystein P. Long-Term Results After Surgery for Degenerative Cervical Myelopathy |
topic_facet |
Neurology (clinical) Surgery |
description |
BACKGROUND AND OBJECTIVES: Degenerative cervical myelopathy (DCM) is a frequent cause of spinal cord dysfunction, and surgical treatment is considered safe and effective. Long-term results after surgery are limited. This study investigated long-term clinical outcomes through data from the Norwegian registry for spine surgery. METHODS: Patients operated at the university hospitals serving Central and Northern Norway were approached for long-term follow-up after 3 to 8 years. The primary outcome was change in the Neck Disability Index, and the secondary outcomes were changes in the European Myelopathy Scale score, quality of life (EuroQoL EQ-5D); numeric rating scales (NRS) for headache, neck pain, and arm pain; and perceived benefit of surgery assessed by the Global Perceived Effect scale from 1 year to long-term follow-up. RESULTS: We included 144 patients operated between January 2013 and June 2018. In total, 123 participants (85.4%) provided patient-reported outcome measures (PROMs) at long-term follow-up. There was no significant change in PROMs from 1 year to long-term follow-up, including Neck Disability Index (mean 1.0, 95% CI −2.1-4.1, P = .53), European Myelopathy Scale score (mean −0.3, 95% CI −0.7-0.1, P = .09), EQ-5D index score (mean −0.02, 95% CI −0.09-0.05, P = .51), NRS neck pain (mean 0.3 95% CI −0.2-0.9, P = .22), NRS arm pain (mean −0.1, 95% CI −0.8-0.5, P = .70), and NRS headache (mean 0.4, 95% CI −0.1-0.9, P = .11). According to Global Perceived Effect assessments, 106/121 patients (87.6%) reported to be stable or improved (“complete recovery,” “much better,” “slightly better,” or “unchanged”) at long-term follow-up compared with 88.1% at 1 year. Dichotomizing the outcome data based on severity of DCM did not demonstrate significant changes either. CONCLUSION: Long-term follow-up of patients undergoing surgery for DCM demonstrates persistence of statistically significant and clinically meaningful improvement across a wide range of PROMs. |
format |
Article in Journal/Newspaper |
author |
Johansen, Tonje O. Holmberg, Siril T. Danielsen, Elisabet Rao, Vidar Salvesen, Øyvind O. Andresen, Hege Carmen, Vleggeert-Lankamp L. A. Solberg, Tore K. Gulati, Sasha Nygaard, Øystein P. |
author_facet |
Johansen, Tonje O. Holmberg, Siril T. Danielsen, Elisabet Rao, Vidar Salvesen, Øyvind O. Andresen, Hege Carmen, Vleggeert-Lankamp L. A. Solberg, Tore K. Gulati, Sasha Nygaard, Øystein P. |
author_sort |
Johansen, Tonje O. |
title |
Long-Term Results After Surgery for Degenerative Cervical Myelopathy |
title_short |
Long-Term Results After Surgery for Degenerative Cervical Myelopathy |
title_full |
Long-Term Results After Surgery for Degenerative Cervical Myelopathy |
title_fullStr |
Long-Term Results After Surgery for Degenerative Cervical Myelopathy |
title_full_unstemmed |
Long-Term Results After Surgery for Degenerative Cervical Myelopathy |
title_sort |
long-term results after surgery for degenerative cervical myelopathy |
publisher |
Ovid Technologies (Wolters Kluwer Health) |
publishDate |
2023 |
url |
http://dx.doi.org/10.1227/neu.0000000000002712 https://journals.lww.com/10.1227/neu.0000000000002712 |
geographic |
Norway |
geographic_facet |
Norway |
genre |
Northern Norway |
genre_facet |
Northern Norway |
op_source |
Neurosurgery volume 94, issue 3, page 454-460 ISSN 0148-396X 1524-4040 |
op_rights |
http://creativecommons.org/licenses/by-nc-nd/4.0/ |
op_doi |
https://doi.org/10.1227/neu.0000000000002712 |
container_title |
Neurosurgery |
_version_ |
1794405169908154368 |