PMID- 35051639 OWN - NLM STAT- MEDLINE DCOM- 20220405 LR - 20220823 IS - 1878-8769 (Electronic) IS - 1878-8750 (Linking) VI - 160 DP - 2022 Apr TI - Differences in Patient-Reported Outcomes Between Anterior and Posterior Approaches for Treatment of Cervical Spondylotic Myelopathy: A Quality Outcomes Database Analysis. PG - e436-e441 LID - S1878-8750(22)00052-3 [pii] LID - 10.1016/j.wneu.2022.01.049 [doi] AB - OBJECTIVE: Surgery for cervical spondylotic myelopathy (CSM) may use anterior or posterior approaches. Our objective was to compare baseline differences and validated postoperative patient-reported outcome measures between anterior and posterior approaches. METHODS: The NeuroPoint Quality Outcomes Database was queried retrospectively to identify patients with symptomatic CSM treated at 14 high-volume sites. Demographic, comorbidity, socioeconomic, and outcome measures were compared between treatment groups at baseline and 3 and 12 months postoperatively. RESULTS: Of the 1151 patients with CSM in the cervical registry, 791 (68.7%) underwent anterior surgery and 360 (31.3%) underwent posterior surgery. Significant baseline differences were observed in age, comorbidities, myelopathy severity, unemployment, and length of hospital stay. After adjusting for these differences, anterior surgery patients had significantly lower Neck Disability Index score (NDI) and a higher proportion reaching a minimal clinically important difference (MCID) in NDI (P = 0.005 at 3 months; P = 0.003 at 12 months). Although modified Japanese Orthopaedic Association scores were lower in anterior surgery patients at 3 and 12 months (P < 0.001 and P = 0.022, respectively), no differences were seen in MCID or change from baseline. Greater EuroQol-5D improvement at 3 months after anterior versus posterior surgery (P = 0.024) was not sustained at 12 months and was insignificant on multivariate analysis. CONCLUSIONS: In the largest analysis to date of CSM surgery data, significant baseline differences existed for patients undergoing anterior versus posterior surgery for CSM. After adjusting for these differences, patients undergoing anterior surgery were more likely to achieve clinically significant improvement in NDI at short- and long-term follow-up. CI - Copyright (c) 2022 Elsevier Inc. All rights reserved. FAU - Wilkerson, Christopher G AU - Wilkerson CG AD - Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA. FAU - Sherrod, Brandon A AU - Sherrod BA AD - Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA. FAU - Alvi, Mohammed Ali AU - Alvi MA AD - Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA. FAU - Asher, Anthony L AU - Asher AL AD - Department of Neurosurgery, Carolina Neurosurgery and Spine Associates and Neuroscience Institute, Carolinas HealthCare System, Charlotte, North Carolina, USA. FAU - Coric, Domagoj AU - Coric D AD - Department of Neurosurgery, Carolina Neurosurgery and Spine Associates and Neuroscience Institute, Carolinas HealthCare System, Charlotte, North Carolina, USA. FAU - Virk, Michael S AU - Virk MS AD - Department of Neurosurgery, Weill Cornell Medical College, New York, New York, USA. FAU - Fu, Kai-Ming AU - Fu KM AD - Department of Neurosurgery, Weill Cornell Medical College, New York, New York, USA. FAU - Foley, Kevin T AU - Foley KT AD - Department of Neurosurgery, University of Tennessee and Semmes Murphy Clinic, Memphis, Tennessee, USA. FAU - Park, Paul AU - Park P AD - Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA. FAU - Upadhyaya, Cheerag D AU - Upadhyaya CD AD - Saint Luke's Neurological and Spine Surgery, Kansas City, Missouri, USA. FAU - Knightly, John J AU - Knightly JJ AD - Atlantic Neurosurgical Specialists, Morristown, New Jersey, USA. FAU - Shaffrey, Mark E AU - Shaffrey ME AD - Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia, USA. FAU - Potts, Eric A AU - Potts EA AD - Department of Neurosurgery, Indiana University; Goodman Campbell Brain and Spine, Indianapolis, Indiana, USA. FAU - Shaffrey, Christopher AU - Shaffrey C AD - Department of Neurosurgery, Duke University, Durham, North Carolina, USA. FAU - Wang, Michael Y AU - Wang MY AD - Department of Neurosurgery, University of Miami, Miami, Florida, USA. FAU - Mummaneni, Praveen V AU - Mummaneni PV AD - Department of Neurosurgery, University of California, San Francisco, California, USA. FAU - Chan, Andrew K AU - Chan AK AD - Department of Neurosurgery, University of California, San Francisco, California, USA. FAU - Bydon, Mohamad AU - Bydon M AD - Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA. FAU - Tumialan, Luis M AU - Tumialan LM AD - Barrow Brain and Spine, Phoenix, Arizona, USA. FAU - Bisson, Erica F AU - Bisson EF AD - Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA. Electronic address: neuropub@hsc.utah.edu. LA - eng PT - Journal Article DEP - 20220118 PL - United States TA - World Neurosurg JT - World neurosurgery JID - 101528275 SB - IM MH - Cervical Vertebrae/surgery MH - Humans MH - Patient Reported Outcome Measures MH - Retrospective Studies MH - *Spinal Cord Diseases/surgery MH - *Spondylosis/surgery MH - Treatment Outcome OTO - NOTNLM OT - Cervical myelopathy OT - Cervical spine OT - Neck Disability Index OT - Patient-reported outcome OT - Quality of life EDAT- 2022/01/21 06:00 MHDA- 2022/04/06 06:00 CRDT- 2022/01/20 20:17 PHST- 2021/12/03 00:00 [received] PHST- 2022/01/10 00:00 [revised] PHST- 2022/01/11 00:00 [accepted] PHST- 2022/01/21 06:00 [pubmed] PHST- 2022/04/06 06:00 [medline] PHST- 2022/01/20 20:17 [entrez] AID - S1878-8750(22)00052-3 [pii] AID - 10.1016/j.wneu.2022.01.049 [doi] PST - ppublish SO - World Neurosurg. 2022 Apr;160:e436-e441. doi: 10.1016/j.wneu.2022.01.049. Epub 2022 Jan 18.