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Surgical Outcomes in Patients with Congenital Cervical Spinal Stenosis.
World Neurosurg. 2020 Jun 06 [Online ahead of print]WN

Abstract

OBJECTIVE

To evaluate the differences in surgical outcomes of patients with cervical spondylotic myelopathy with and without congenital cervical spinal stenosis (CCSS).

METHODS

Institutional review board approval was obtained to conduct a retrospective chart review of patients with cervical spondylotic myelopathy who underwent decompression and fusion surgeries from 2010-2016 at a single institution. CCSS was identified using the Torg-Pavlov ratio on lateral cervical radiographs. Pre- and postoperative outcome measures were assessed using the modified Japanese Orthopedic Association (mJOA) and the EuroQol 5-dimension questionnaire (EQ-5D).

RESULTS

Of 208 patients, Torg-Pavlov ratio identified 85 patients with CCSS. There were no significant differences between the CCSS patient and control patient groups in EuroQol 5-dimension questionnaire and mJOA scores at all 4 designated time points in the study (preoperative, earliest postoperative, 6 month postoperative, and 1 year postoperative). Although not statistically significantly, there was a notable trend for patients with CCSS to be less likely to have mJOA-defined severe myelopathy at the postoperative (odds ratio [OR], 0.75; P = 0.38), 6 month postoperative (OR, 0.66; P = 0.20), and 1 year postoperative (OR, 0.64; P = 0.14) time points.

CONCLUSIONS

Postoperatively, compared with non-CCSS patients, patients with congenital cervical stenosis reported equal quality of life for all markers. Our findings suggest that in patients with CCSS and relatively mild symptoms of myelopathy, equal consideration should be given for surgical intervention. The findings of this study warrant further large-scale, multi-institutional investigation to further understand the generalizability of these surgical outcome results.

Authors+Show Affiliations

Case Western Reserve School of Medicine, Cleveland, Ohio, USA.Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.Department of Urology, Weill Cornell Medical College, New York, New York, USA.Department of Orthopedic Surgery, University of Missouri, Columbia, Missouri, USA.Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio, USA.Center for Spine Health, Cleveland Clinic, Cleveland, Ohio, USA. Electronic address: mrozt@ccf.org.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32522653

Citation

Atli, Karam, et al. "Surgical Outcomes in Patients With Congenital Cervical Spinal Stenosis." World Neurosurgery, 2020.
Atli K, Chakravarthy V, Khan AI, et al. Surgical Outcomes in Patients with Congenital Cervical Spinal Stenosis. World Neurosurg. 2020.
Atli, K., Chakravarthy, V., Khan, A. I., Moore, D., Steinmetz, M. P., & Mroz, T. E. (2020). Surgical Outcomes in Patients with Congenital Cervical Spinal Stenosis. World Neurosurgery. https://doi.org/10.1016/j.wneu.2020.05.252
Atli K, et al. Surgical Outcomes in Patients With Congenital Cervical Spinal Stenosis. World Neurosurg. 2020 Jun 6; PubMed PMID: 32522653.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical Outcomes in Patients with Congenital Cervical Spinal Stenosis. AU - Atli,Karam, AU - Chakravarthy,Vikram, AU - Khan,Aleem I, AU - Moore,Don, AU - Steinmetz,Michael P, AU - Mroz,Thomas E, Y1 - 2020/06/06/ PY - 2020/03/07/received PY - 2020/05/26/revised PY - 2020/05/28/accepted PY - 2020/6/12/pubmed PY - 2020/6/12/medline PY - 2020/6/12/entrez KW - Anterior cervical discectomy and fusion KW - Cervical spine surgery KW - Cervical spondylotic myelopathy KW - Congenital cervical spinal stenosis KW - Posterior cervical decompression and fusion JF - World neurosurgery JO - World Neurosurg N2 - OBJECTIVE: To evaluate the differences in surgical outcomes of patients with cervical spondylotic myelopathy with and without congenital cervical spinal stenosis (CCSS). METHODS: Institutional review board approval was obtained to conduct a retrospective chart review of patients with cervical spondylotic myelopathy who underwent decompression and fusion surgeries from 2010-2016 at a single institution. CCSS was identified using the Torg-Pavlov ratio on lateral cervical radiographs. Pre- and postoperative outcome measures were assessed using the modified Japanese Orthopedic Association (mJOA) and the EuroQol 5-dimension questionnaire (EQ-5D). RESULTS: Of 208 patients, Torg-Pavlov ratio identified 85 patients with CCSS. There were no significant differences between the CCSS patient and control patient groups in EuroQol 5-dimension questionnaire and mJOA scores at all 4 designated time points in the study (preoperative, earliest postoperative, 6 month postoperative, and 1 year postoperative). Although not statistically significantly, there was a notable trend for patients with CCSS to be less likely to have mJOA-defined severe myelopathy at the postoperative (odds ratio [OR], 0.75; P = 0.38), 6 month postoperative (OR, 0.66; P = 0.20), and 1 year postoperative (OR, 0.64; P = 0.14) time points. CONCLUSIONS: Postoperatively, compared with non-CCSS patients, patients with congenital cervical stenosis reported equal quality of life for all markers. Our findings suggest that in patients with CCSS and relatively mild symptoms of myelopathy, equal consideration should be given for surgical intervention. The findings of this study warrant further large-scale, multi-institutional investigation to further understand the generalizability of these surgical outcome results. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/32522653/Surgical_Outcomes_in_Patients_with_Congenital_Cervical_Spinal_Stenosis L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(20)31225-0 DB - PRIME DP - Unbound Medicine ER -
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