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Article: Effectiveness of 3 surgical decompression strategies for treatment of multilevel cervical myelopathy in 3 spinal centers in China: A retrospective study

TitleEffectiveness of 3 surgical decompression strategies for treatment of multilevel cervical myelopathy in 3 spinal centers in China: A retrospective study
Authors
Keywords1-stage posterior-anterior strategy
anterior strategy
cervical myelopathy
complications
posterior strategy
Issue Date2012
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
Citation
Spine, 2012, v. 37 n. 17, p. 1463-1469 How to Cite?
AbstractSTUDY DESIGN. Retrospective multicenter study. OBJECTIVE. To compare clinical outcomes and surgical-related adverse events in patients with multilevel cervical myelopathy (MCM) undergoing simple anterior, simple posterior, or 1-stage posterior-anterior surgical decompression strategies. SUMMARY OF BACKGROUND DATA. Simple anterior, simple posterior, and 1-stage posterior-anterior surgical decompression strategies have been advocated for MCM treatment in both Western and Chinese populations. However, there is limited evidence on whether 1-stage posterior-anterior strategy may offer equal or more advantages than the other 2 strategies for patients with MCM. METHODS. A retrospective review of medical records was conducted for 255 patients with MCM who had undergone surgical decompression in 3 Chinese spinal centers from 1999 to 2010. Neurological status, perioperative variables, and surgical complications were assessed. Multiple linear regression was used to evaluate factors associated with the outcomes of each strategy. RESULTS. Analyses were conducted on a total of 229 patients with MCM undergoing surgical decompression via 1-stage posterior-anterior (68 patients), simple anterior (102 patients), and simple posterior approaches (59 patients). One-stage posterior-anterior approach had the highest Japanese Orthopaedic Association recovery rate after adjusted for age and sex (adjusted mean ± SD: 50.0 ± 3.2, P < 0.001) and additionally adjusted for smoking, duration from onset of symptoms to surgery, comorbidities, preoperative Japanese Orthopaedic Association score, Ishihara's curvature index and Pavlov ratio, operative blood loss, operating time, anterior operated disc levels, and posterior operated levels (adjusted mean ± SD: 51.6 ± 11.6, P < 0.01). Anterior approach had the largest difference between the pre-and postoperative Ishihara's curvature indexes after adjusted for age and sex (adjusted mean ± SD: 5.3 ± 1.0, P < 0.01) and after multivariable adjustment (adjusted mean ± SD: 6.5 ± 2.8, P = 0.003). CONCLUSION. One-stage posterior-anterior strategy can be a reliable and effective treatment strategy for MCM in a subgroup of patients with anterior and posterior compression on spinal cord simultaneously. © 2012, Lippincott Williams &Wilkins.
Persistent Identifierhttp://hdl.handle.net/10722/164795
ISSN
2015 Impact Factor: 2.439
2015 SCImago Journal Rankings: 1.459
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWen, SFen_HK
dc.contributor.authorWong, IOLen_HK
dc.contributor.authorLong, MJen_HK
dc.contributor.authorLi, JGen_HK
dc.contributor.authorLi, XFen_HK
dc.contributor.authorGuo, DMen_HK
dc.contributor.authorXu, ZHen_HK
dc.contributor.authorYin, QSen_HK
dc.date.accessioned2012-09-20T08:09:41Z-
dc.date.available2012-09-20T08:09:41Z-
dc.date.issued2012en_HK
dc.identifier.citationSpine, 2012, v. 37 n. 17, p. 1463-1469en_HK
dc.identifier.issn0362-2436en_HK
dc.identifier.urihttp://hdl.handle.net/10722/164795-
dc.description.abstractSTUDY DESIGN. Retrospective multicenter study. OBJECTIVE. To compare clinical outcomes and surgical-related adverse events in patients with multilevel cervical myelopathy (MCM) undergoing simple anterior, simple posterior, or 1-stage posterior-anterior surgical decompression strategies. SUMMARY OF BACKGROUND DATA. Simple anterior, simple posterior, and 1-stage posterior-anterior surgical decompression strategies have been advocated for MCM treatment in both Western and Chinese populations. However, there is limited evidence on whether 1-stage posterior-anterior strategy may offer equal or more advantages than the other 2 strategies for patients with MCM. METHODS. A retrospective review of medical records was conducted for 255 patients with MCM who had undergone surgical decompression in 3 Chinese spinal centers from 1999 to 2010. Neurological status, perioperative variables, and surgical complications were assessed. Multiple linear regression was used to evaluate factors associated with the outcomes of each strategy. RESULTS. Analyses were conducted on a total of 229 patients with MCM undergoing surgical decompression via 1-stage posterior-anterior (68 patients), simple anterior (102 patients), and simple posterior approaches (59 patients). One-stage posterior-anterior approach had the highest Japanese Orthopaedic Association recovery rate after adjusted for age and sex (adjusted mean ± SD: 50.0 ± 3.2, P < 0.001) and additionally adjusted for smoking, duration from onset of symptoms to surgery, comorbidities, preoperative Japanese Orthopaedic Association score, Ishihara's curvature index and Pavlov ratio, operative blood loss, operating time, anterior operated disc levels, and posterior operated levels (adjusted mean ± SD: 51.6 ± 11.6, P < 0.01). Anterior approach had the largest difference between the pre-and postoperative Ishihara's curvature indexes after adjusted for age and sex (adjusted mean ± SD: 5.3 ± 1.0, P < 0.01) and after multivariable adjustment (adjusted mean ± SD: 6.5 ± 2.8, P = 0.003). CONCLUSION. One-stage posterior-anterior strategy can be a reliable and effective treatment strategy for MCM in a subgroup of patients with anterior and posterior compression on spinal cord simultaneously. © 2012, Lippincott Williams &Wilkins.en_HK
dc.languageengen_US
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.comen_HK
dc.relation.ispartofSpineen_HK
dc.rightsThis is a non-final version of an article published in final form in Spine, 2012, v. 37 n. 17, p. 1463-1469-
dc.subject1-stage posterior-anterior strategyen_HK
dc.subjectanterior strategyen_HK
dc.subjectcervical myelopathyen_HK
dc.subjectcomplicationsen_HK
dc.subjectposterior strategyen_HK
dc.titleEffectiveness of 3 surgical decompression strategies for treatment of multilevel cervical myelopathy in 3 spinal centers in China: A retrospective studyen_HK
dc.typeArticleen_HK
dc.identifier.emailWong, IOL: iolwong@hku.hken_HK
dc.identifier.authorityWong, IOL=rp01806en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/BRS.0b013e31824ff9bcen_HK
dc.identifier.pmid22842538-
dc.identifier.scopuseid_2-s2.0-84864491257en_HK
dc.identifier.hkuros208046en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84864491257&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume37en_HK
dc.identifier.issue17en_HK
dc.identifier.spage1463en_HK
dc.identifier.epage1469en_HK
dc.identifier.isiWOS:000307068800017-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridWen, SF=12040550800en_HK
dc.identifier.scopusauthoridWong, IOL=7102513940en_HK
dc.identifier.scopusauthoridLong, MJ=37085444400en_HK
dc.identifier.scopusauthoridLi, JG=55325972900en_HK
dc.identifier.scopusauthoridLi, XF=55325957400en_HK
dc.identifier.scopusauthoridGuo, DM=55716408700en_HK
dc.identifier.scopusauthoridXu, ZH=8559355300en_HK
dc.identifier.scopusauthoridYin, QS=7202603867en_HK

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