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  • Laminoplasty vs Laminectomy and Fusion to Treat Cervical Spondylotic Myelopathy: Outcomes of the Prospective Multicenter AOSpine International CSM Study

    Final Number:
    367

    Authors:
    Michael Fehlings; Branko Kopjar; Shashank Sharad Kale; Helton Defino; Giuseppe Barbagallo; Ronald Bartels; Qiang Zhou; Paul Arnold; Mehmet Zileli; Gamaliel Tan; Osmar Moraes; Yasutsugu Yukawa; Manuel Alvarado; Massimo Scerrati; Tomoaki Toyone; Masato Tanaka; Ciaran Bolger

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2014 Annual Meeting

    Introduction: Recent studies conducted in North America have demonstrated benefits of surgical treatment for symptomatic CSM. However, differences in pathology, comorbidities, treatment approaches and cultural response to treatment may affect the generalizability of these findings at the global level.

    Methods: Patients receiving surgery for clinically symptomatic CSM were enrolled in a prospective multicenter, cohort study which is continuing to accrue subjects at 16 sites in Europe, Asia, North and South America. Subjects included were a part of a larger ongoing prospective observational study that has enrolled 492 subjects with CSM involving 16 clinical sites in Europe, Asia, North and South America. Of those, 108 received laminectomy and fusion; 66 received laminoplasty. The choice of surgical approach was at the discretion of the surgeon. Outcome measures were mJOA, the Nurick scale, NDI and the SF36 PCS and MCS Component Scores.

    Results: Average age was 60.2 years (SD 10.8), 29.8% were female. Subjects threated with laminectomy and fusion had more levels operated (5.0 vs. 4.4, P<.01), shorter length of stay (7.7 vs. 15.7 days, P < .01) and, less severe neurologic impairment measured by mJOA (12.6 vs. 11.2, P < .01). There were no differences in age, and baseline NDI, SF36v2 PCS and SF36v2 MCS. At 12 month follow-up, there were no differences in neurologic and functional outcomes for laminoplasty compared to laminectomy and fusion; mJOA (3.0 and 2.3, respectively, P=0.15). Moreover, there were no differences in NDI (13.3 and 12.0, respectively, P=0.71), SF-36v2 PCS (8.5 and 7.7, respectively, P=0.66) and SF-36v2 MCS (7.9 and 6.9, respectively, P=0.56).

    Conclusions: Patients undergoing laminectomy and fusion and laminoplasty surgery for CSM show similar improvements in generic and disease specific outcome measures allowing for baseline differences in clinical presentation between the two groups of patients. Longer term follow-up will be required to determine whether any differences in outcome between the two forms of treatment emerge.

    Patient Care: Patients undergoing laminectomy and fusion and laminoplasty surgery for CSM show similar improvements in generic and disease specific outcome measures allowing for baseline differences in clinical presentation between the two groups of patients</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: Recent studies conducted in North America have demonstrated benefits of surgical treatment for symptomatic CSM.

    References:

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