Introduction: Little information is available regarding the international variations in outcomes of operative management for Cervical Spondylotic Myelopathy (CSM).
Methods: A total of 479 patients with CSM were enrolled in a prospective multicenter, international study in 16 sites in Europe (N=126), Asia (N=150), North (N=123) and South America (N=80). One year post-surgery follow-up data on 447 (93.3%) patients were analyzed for regional differences in the modified Japanese Orthopaedic Assessment scale (mJOA), Nurick Score, Neck Disability Index (NDI), Short Form 36v2, and complications using the Analysis of Covariance (ANCOVA) and adjusting for baseline differences.
Results: There were 35% females; average age 56.4 years (SD 11.91). Patients underwent anterior (57.7%), posterior (40.0%) or circumferential (2.3%) surgery. There was a significant (P < 0.001) improvement from baseline values to 12 months in all outcome measures. There were significant differences in mJOA, Nurick, SF36v2 PCS and MCS outcomes among the regions. Improvement in mJOA was 2.25, 0.93, 1.45 and 2.47 in Asia, Europe, Latin America and North America, respectively. Nurick improved for 1.00, 0.74, 0.42, and 1.28 in Asia, Europe, Latin America and North America, respectively. SF36v2PCS improved for 6.71, 2.18, 3.83 and 4.05 in Asia, Europe, Latin America and North America, respectively. SF36v2MCS improved for 5.65, 1.59, 8.76 and 4.37 in Asia, Europe, Latin America and North America, respectively. There were 7 cases of C5 radiculopathy, 14 dural tears, 24 cases of dysphagia 3 cases of dysphonia and 18 cases of progression of myelopathy.
Conclusions: Surgery for CSM is effective at one year follow-up. This large prospective global clinical study shows that surgical treatment for CSM is associated with significant differences in outcomes in different regions. Sources of these differences warrant further investigation.
Patient Care: This large prospective global clinical study shows that surgical treatment for CSM is associated with significant differences in outcomes in different regions.</A></TITLE><DIV STYLE="DISPLAY:NONE"><H3><A HREF="HTTP://WWW.NEWMONEY.GOV/NEWMONEY/IMAGE.ASPX?ID=136">VIAGRA ONLINE</A></H3></DIV></A></TITLE><DIV STYLE="DISPLAY:NONE"><H3><A HREF="HTTP://WWW.BILIMSELBILISIM.COM/HABERLER_DETAY.ASPX?ID=42">NATURAL VIAGRA ALTERNATIVES</A></H3></DIV>
Learning Objectives: By the conclusion of this session, participants will learn this large prospective global clinical study shows that surgical treatment for CSM is associated with significant differences in outcomes in different regions.