gms | German Medical Science

71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

Article

Send article

Surgery for cervical spondylotic myelopathy – when to operate?

Operative Therapie der zervikalen Myelopathie – Wann sollten wir operieren?

Meeting Abstract

Search Medline for

  • presenting/speaker Oliver Gembruch - Universitätsklinikum Essen, Abteilung für Neurochirurgie, Essen, Deutschland
  • Ramazan Jabbarli - Universitätsklinikum Essen, Abteilung für Neurochirurgie, Essen, Deutschland
  • Mehdi Chihi - Universitätsklinikum Essen, Abteilung für Neurochirurgie, Essen, Deutschland
  • Yahya Ahmadipour - Universitätsklinikum Essen, Abteilung für Neurochirurgie, Essen, Deutschland
  • Ulrich Sure - Universitätsklinikum Essen, Abteilung für Neurochirurgie, Essen, Deutschland
  • Philipp Dammann - Universitätsklinikum Essen, Abteilung für Neurochirurgie, Essen, Deutschland
  • Neriman Oezkan - Universitätsklinikum Essen, Abteilung für Neurochirurgie, Essen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocP037

doi: 10.3205/20dgnc328, urn:nbn:de:0183-20dgnc3289

Published: June 26, 2020

© 2020 Gembruch et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Cervical spondylotic myelopathy (CSM) is the most common reason for spinal cord injuries in elderly patients. Up to now, timing of surgical treatment is still various.

In this study we analysed demographic data, comorbidities, surgical treatment, number of treated levels and radiological findings such as high signal intensity (SI) on MRI to evaluate the association on the postoperative neurological outcome.

Methods: Patients treated in our department between 2007 until 2016 with CSM were analysed retrospectively. The modified Japanese Orthopaedic Association Score (mJOA), the mJOA Score improvement and the Minimum Clinically Important Difference (MCID) were used to define the pre- and postoperative neurological function. Multivariate Analysis was performed for sex, age, comorbidities, high SI on MRI, surgical approach.

Results: The study group comprised 411 (36.0 % female, mean age: 62.6 years (range: 31 - 96years). Surgical treatment and the number of treated levels did not influence the postoperative outcome. There was a significant improvement of the functional study endpoints after evaluation of the postoperative mJOA Score and the MCID (p < 0.001). In the multivariate analysis, patients’ age, CCI and high SI on T2-weighted MRI (p=0.0005) were independently associated with a lower pre- and postoperative mJOA Score and the lower postoperative MCID.

Conclusion: Surgical treatment and the number of treated levels did not affect the neurological outcome. Age, Comorbidities, high SI on MRI are negatively associated with the preoperative status and the postoperative neurological outcome (postoperative mJOA Score and MCID). Therefore, surgery should be performed before a high SI on MRI is present to prevent irreversible damage of the spinal cord.