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  • Do Racial Differences Affect Surgical Outcomes in Patients with Degenerative Cervical Myelopathy? Results from the Prospective, Multicenter AOSpine International Study on 479 Patients

    Final Number:
    349

    Authors:
    Narihito Nagoshi MD, PhD; Lindsay Tetreault Bsc; Hiroaki Nakashima MD; Aria Nouri BA, MD; Branko Kopjar MD; Paul M. Arnold MD; Michael G. Fehlings MD, PhD, FRCS(C), FACS

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: Previous studies have highlighted racial differences in the pathology of degenerative cervical myelopathy (DCM), including a higher prevalence of ossification of the posterior longitudinal ligament (OPLL) in Asian populations. The objective of this study is to compare surgical outcomes between Caucasians and Asians with DCM and to determine whether race is an independent predictor of surgical outcomes.

    Methods: Patient demographics, causative pathology and surgical summaries were statistically compared between the two races. A mixed model analytic approach was used to evaluate differences in surgical outcome between Caucasians and Asians, while controlling for relevant baseline characteristics and surgical factors.

    Results: Of the 479 DCM patients enrolled in the AOSpine CSM-International study, 324 (67.64%) were Caucasian, and 106 East Asian (22.13%). Caucasians had a significantly longer duration of symptoms and a greater number of co-morbidities than East Asians. Surprisingly, there was no difference in the incidence of OPLL between the two races; however a greater percentage of Caucasians in Asia exhibited OPLL than Caucasians in Europe or North America. With respect to outcome, patients from East Asia had significantly higher scores on the mJOA, Nurick and SF-36v2. After adjusting for key differences in patient characteristics and surgical features, these differences in functional status and quality of life between the two races remained significant. However, when adjusting for region, the differences in the mJOA and SF-36v2 became insignificant.

    Conclusions: Based on these results, environmental or societal factors may influence surgical outcome. Race is therefore not an independent predictor of functional status or quality of life.

    Patient Care: The objective of this study is to compare surgical outcomes between Caucasians and Asians with DCM and to determine whether race is an independent predictor of surgical outcomes.

    Learning Objectives: To compare surgical outcomes between Caucasians and Asians with DCM and to determine whether race is an independent predictor of surgical outcomes.

    References:

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