gms | German Medical Science

63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

13. - 16. Juni 2012, Leipzig

Does surgical therapy in case of cervical spondylotic myelopathy (CSM) improve the mid-term results particularly concerning quality of life?

Meeting Abstract

  • R. Bostelmann - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf
  • V. Siebel - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf
  • H.J. Steiger - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf
  • J.F. Cornelius - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocFR.03.02

DOI: 10.3205/12dgnc188, URN: urn:nbn:de:0183-12dgnc1880

Veröffentlicht: 4. Juni 2012

© 2012 Bostelmann et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: In this retrospective cohort study the surgical decompression procedures were evaluated in patients with CSM due to cervical spine stenosis. Long-term outcome was determined to judge the effects of illness or the influence of therapy. The analysis focused on patient’s satisfaction, disablement and general state of health as parameters for quality of life (QOL) and the surgically technical status.

Methods: Between Nov. 2005 and June 2010 45 patients were decompressed surgically. Radiological evaluation was done. Neurological status and QOL were assessed by JOA score (Japanese Orthopaedic association), a 33 item questionnaire and Neck Disability Index (NDI). On average 2,89 ± 1,37 clinical and radiological examinations were performed per patient.

Results: Out of the study group (45 Pat, m: 33, w: 12, 63 ± 11,11 years) QOL improved in 17, remained unchanged in 20, worsened in 8. Final follow-up was after 29,69 ± 14,43 months. Patients with an improved QOL had presurgical JOA score of 12,12 ± 3,38, topical JOA score of 12,15 ± 3,55 and NDI of 25,76 ± 17,15. Pat with unchanged quality of life showed presurgical JOA score of 8,93 ± 4,69, topical of 10,38 ± 4,66 and the NDI of 34,80 ± 24,51. Patients with worsening showed presurgical JOA score of 10,88 ± 3,70, topical JOA score of 10,38 ± 2,99 and the NDI of 46,63 ± 17,46. In the whole study group, the average presurgical JOA score was 10,48 ± 4,24, at follow up the JOA score was 11,04 ± 4,02 and NDI was 33,49 ± 21,68. Comparing presurgical JOA score to the topical, this improved in 21 cases, remained unchanged in 14 and worsened in 10.

Conclusions: 82% showed improvement or maintenance of presurgically QOL, so that the effectiveness of the surgical procedure as well as a positive influence on QOL may be postulated. But on the other hand a significant change in the JOA could not be demonstrated. So in terms of patient relevant items in mid-term follow-up JOA scores seem to be less significant as compared to QOL assessment.