Hong Kong Spine Surgery Registry - Cervical Myelopathy

Abstract

Introduction

A patient registry is a database of patients, which includes personal information, clinical information and/or information on complications, collected in a systematic and comprehensive way. It is a valuable tool for providing a real-world view of clinical practice, patient outcomes, safety and effectiveness. However, there is yet to be a patient registry of Orthopaedic Spinal interventions in Hong Kong.

Objectives

(1) To establish a cross-hospital patient registry for spine surgeries, with cervical myelopathy as the pilot pathology; (2) To review surgical varieties; (3) To review clinical outcomes and surgical complications; (4) To initiate multi-hospitals participation. Local database provides clinical information to patients regarding the surgical options, likely outcome and chance of complications. By comparing with overseas data, we understand our performance and improve our clinical care if necessary.

Methodology

A patient registry was developed among Queen Elizabeth Hospital, Queen Mary Hospital, Tuen Mun Hospital and United Christian Hospital. All patients with cervical myelopathy in the sub-axial levels (from C2/3 to C7/T1) treated surgically from 01 May 2017 were input into a computer system solely developed for the registry. Exclusion criteria include myelopathy contributed by pathology above C2/3; trauma history within 1 year; infection; tumour and concomitant cervical radiculopathy. Patient demographics, clinical information, surgical procedures, complications and outcomes were recorded.

Results & Outcome

From May 2017 to Dec 2018, there were 181 patients included in the registry. One hundred and eighteen patients were male and 63 were female. The mean age at surgery was 63 (range, 30 - 88 years). Anterior procedures were performed on 36 patients; 143 patients received posterior procedures and 2 patients received combined approach procedures. The Hong Kong Spine Surgery Registry – Cervical Myelopathy is a pilot registry programme and was effective to collect clinical information, to understand variations in current treatment practices and to collect longitudinal follow-up data on clinical outcomes. This demonstrates that multi-centre clinical outcome database is achievable in Hong Kong and this registry can function as a model.