Surgery for Degenerative Cervical Myelopathy: A Nationwide Registry-Based Observational Study With Patient-Reported Outcomes
Abstract 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...
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| Veröffentlicht in: | Neurosurgery 2021-10, Vol.89 (4), p.704-711 |
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| creator | 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 |
| description | Abstract
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 |
| doi_str_mv | 10.1093/neuros/nyab259 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_3HK</sourceid><recordid>TN_cdi_cristin_nora_10037_23625</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/neuros/nyab259</oup_id><sourcerecordid>2575281530</sourcerecordid><originalsourceid>FETCH-LOGICAL-c453t-cb2ab167063890ce0ff87c2d5535b868fdba164a927d70aeaac4b3a749ef9b9a3</originalsourceid><addsrcrecordid>eNqFkUtv1DAUhS0EokNhyxZLbGCR1s84YVGpDE-pUNSCYGc5zs2Mq0wcbGdQJH48ns6ABBtWlny_c-7jIPSYkhNKan46wBR8PB1m0zBZ30ELKpkoBBHkLloQKqqC1-W3I_QgxhtCaClUdR8dccGZFIou0M_rKawgzLjzAb-CFQwQTHJbwEsIW2dNjz_M0PvRpPX8Ap_jj7nqhx-uBXwFKxdTmIuXJkKLL5uYJbflrLpOUzvjry6t8af8B0MqrmD0Ie3IKVm_gfgQ3etMH-HR4T1GX968_rx8V1xcvn2_PL8orJA8FbZhpqGlIiWvamKBdF2lLGul5LKpyqprG5M3MzVTrSIGjLGi4UaJGrq6qQ0_Rmd733FqNtDaPEwwvR6D25gwa2-c_rsyuLVe-a2ucn9eyWzwZG9gQ97YDXrwwWhKCFea8ZLtiGeHFsF_nyAmvXHRQt-bAfwUNZNSMVbRW_TpP-iNn0K-2Y5SMkOSk0yd_G7pYwzQ_RmXEr2LXu-j14fos-D5XuCn8X_sL6chs4A</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2575281530</pqid></control><display><type>article</type><title>Surgery for Degenerative Cervical Myelopathy: A Nationwide Registry-Based Observational Study With Patient-Reported Outcomes</title><source>NORA - Norwegian Open Research Archives</source><creator>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</creator><creatorcontrib>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</creatorcontrib><description><![CDATA[Abstract
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.
Graphical Abstract
Graphical Abstract]]></description><identifier>ISSN: 0148-396X</identifier><identifier>ISSN: 1524-4040</identifier><identifier>EISSN: 1524-4040</identifier><identifier>DOI: 10.1093/neuros/nyab259</identifier><identifier>PMID: 34325471</identifier><language>eng</language><publisher>Philadelphia: Oxford University Press</publisher><subject>Back surgery ; Clinical outcomes ; Degenerative disc disease ; Headaches ; Hospitals ; Magnetic resonance imaging ; Neck pain ; Neurosurgery ; Observational studies ; Patients ; Quality of life ; Questionnaires ; Research—Human—Clinical Studies ; Spinal cord</subject><ispartof>Neurosurgery, 2021-10, Vol.89 (4), p.704-711</ispartof><rights>Congress of Neurological Surgeons 2021. 2021</rights><rights>Congress of Neurological Surgeons 2021.</rights><rights>info:eu-repo/semantics/openAccess</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c453t-cb2ab167063890ce0ff87c2d5535b868fdba164a927d70aeaac4b3a749ef9b9a3</citedby><cites>FETCH-LOGICAL-c453t-cb2ab167063890ce0ff87c2d5535b868fdba164a927d70aeaac4b3a749ef9b9a3</cites><orcidid>0000-0002-3617-3734</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,776,881,26546</link.rule.ids><linktorsrc>$$Uhttp://hdl.handle.net/10037/23625$$EView_record_in_NORA$$FView_record_in_$$GNORA$$Hfree_for_read</linktorsrc></links><search><creatorcontrib>Gulati, Sasha</creatorcontrib><creatorcontrib>Vangen-Lønne, Vetle</creatorcontrib><creatorcontrib>Nygaard, Øystein P</creatorcontrib><creatorcontrib>Gulati, Agnete M</creatorcontrib><creatorcontrib>Hammer, Tommy A</creatorcontrib><creatorcontrib>Johansen, Tonje O</creatorcontrib><creatorcontrib>Peul, Wilco C</creatorcontrib><creatorcontrib>Salvesen, Øyvind O</creatorcontrib><creatorcontrib>Solberg, Tore K</creatorcontrib><title>Surgery for Degenerative Cervical Myelopathy: A Nationwide Registry-Based Observational Study With Patient-Reported Outcomes</title><title>Neurosurgery</title><description><![CDATA[Abstract
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.
Graphical Abstract
Graphical Abstract]]></description><subject>Back surgery</subject><subject>Clinical outcomes</subject><subject>Degenerative disc disease</subject><subject>Headaches</subject><subject>Hospitals</subject><subject>Magnetic resonance imaging</subject><subject>Neck pain</subject><subject>Neurosurgery</subject><subject>Observational studies</subject><subject>Patients</subject><subject>Quality of life</subject><subject>Questionnaires</subject><subject>Research—Human—Clinical Studies</subject><subject>Spinal cord</subject><issn>0148-396X</issn><issn>1524-4040</issn><issn>1524-4040</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><sourceid>BENPR</sourceid><sourceid>3HK</sourceid><recordid>eNqFkUtv1DAUhS0EokNhyxZLbGCR1s84YVGpDE-pUNSCYGc5zs2Mq0wcbGdQJH48ns6ABBtWlny_c-7jIPSYkhNKan46wBR8PB1m0zBZ30ELKpkoBBHkLloQKqqC1-W3I_QgxhtCaClUdR8dccGZFIou0M_rKawgzLjzAb-CFQwQTHJbwEsIW2dNjz_M0PvRpPX8Ap_jj7nqhx-uBXwFKxdTmIuXJkKLL5uYJbflrLpOUzvjry6t8af8B0MqrmD0Ie3IKVm_gfgQ3etMH-HR4T1GX968_rx8V1xcvn2_PL8orJA8FbZhpqGlIiWvamKBdF2lLGul5LKpyqprG5M3MzVTrSIGjLGi4UaJGrq6qQ0_Rmd733FqNtDaPEwwvR6D25gwa2-c_rsyuLVe-a2ucn9eyWzwZG9gQ97YDXrwwWhKCFea8ZLtiGeHFsF_nyAmvXHRQt-bAfwUNZNSMVbRW_TpP-iNn0K-2Y5SMkOSk0yd_G7pYwzQ_RmXEr2LXu-j14fos-D5XuCn8X_sL6chs4A</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Gulati, Sasha</creator><creator>Vangen-Lønne, Vetle</creator><creator>Nygaard, Øystein P</creator><creator>Gulati, Agnete M</creator><creator>Hammer, Tommy A</creator><creator>Johansen, Tonje O</creator><creator>Peul, Wilco C</creator><creator>Salvesen, Øyvind O</creator><creator>Solberg, Tore K</creator><general>Oxford University Press</general><general>Wolters Kluwer Health, Inc</general><scope>TOX</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>3HK</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3617-3734</orcidid></search><sort><creationdate>20211001</creationdate><title>Surgery for Degenerative Cervical Myelopathy: A Nationwide Registry-Based Observational Study With Patient-Reported Outcomes</title><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></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c453t-cb2ab167063890ce0ff87c2d5535b868fdba164a927d70aeaac4b3a749ef9b9a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Back surgery</topic><topic>Clinical outcomes</topic><topic>Degenerative disc disease</topic><topic>Headaches</topic><topic>Hospitals</topic><topic>Magnetic resonance imaging</topic><topic>Neck pain</topic><topic>Neurosurgery</topic><topic>Observational studies</topic><topic>Patients</topic><topic>Quality of life</topic><topic>Questionnaires</topic><topic>Research—Human—Clinical Studies</topic><topic>Spinal cord</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gulati, Sasha</creatorcontrib><creatorcontrib>Vangen-Lønne, Vetle</creatorcontrib><creatorcontrib>Nygaard, Øystein P</creatorcontrib><creatorcontrib>Gulati, Agnete M</creatorcontrib><creatorcontrib>Hammer, Tommy A</creatorcontrib><creatorcontrib>Johansen, Tonje O</creatorcontrib><creatorcontrib>Peul, Wilco C</creatorcontrib><creatorcontrib>Salvesen, Øyvind O</creatorcontrib><creatorcontrib>Solberg, Tore K</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>NORA - Norwegian Open Research Archives</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Gulati, Sasha</au><au>Vangen-Lønne, Vetle</au><au>Nygaard, Øystein P</au><au>Gulati, Agnete M</au><au>Hammer, Tommy A</au><au>Johansen, Tonje O</au><au>Peul, Wilco C</au><au>Salvesen, Øyvind O</au><au>Solberg, Tore K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgery for Degenerative Cervical Myelopathy: A Nationwide Registry-Based Observational Study With Patient-Reported Outcomes</atitle><jtitle>Neurosurgery</jtitle><date>2021-10-01</date><risdate>2021</risdate><volume>89</volume><issue>4</issue><spage>704</spage><epage>711</epage><pages>704-711</pages><issn>0148-396X</issn><issn>1524-4040</issn><eissn>1524-4040</eissn><abstract><![CDATA[Abstract
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.
Graphical Abstract
Graphical Abstract]]></abstract><cop>Philadelphia</cop><pub>Oxford University Press</pub><pmid>34325471</pmid><doi>10.1093/neuros/nyab259</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-3617-3734</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0148-396X |
| ispartof | Neurosurgery, 2021-10, Vol.89 (4), p.704-711 |
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| language | eng |
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| source | NORA - Norwegian Open Research Archives |
| subjects | Back surgery Clinical outcomes Degenerative disc disease Headaches Hospitals Magnetic resonance imaging Neck pain Neurosurgery Observational studies Patients Quality of life Questionnaires Research—Human—Clinical Studies Spinal cord |
| title | Surgery for Degenerative Cervical Myelopathy: A Nationwide Registry-Based Observational Study With Patient-Reported Outcomes |
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