PMID- 36960878
OWN - NLM
STAT- Publisher
LR  - 20240229
IS  - 2192-5682 (Print)
IS  - 2192-5682 (Linking)
DP  - 2023 Mar 24
TI  - Does Ending a Posterior Construct Proximally at C2 Versus C3 Impact Patient 
      Reported Outcomes in Degenerative Cervical Myelopathy Patients up to 24 months 
      After the Surgery?
PG  - 21925682231166605
LID - 10.1177/21925682231166605 [doi]
AB  - STUDY DESIGN: Retrospective cohort study. OBJECTIVES: The primary objective was 
      to evaluate the impact of the upper instrumented level (UIV) being at C2 vs C3 in 
      posterior cervical construct on patient reported outcomes (PROs) up to 24 months 
      after surgery for cervical degenerative myelopathy (DCM). Secondary objectives 
      were to compare operative time, intra-operative blood loss (IOBL), length of stay 
      (LOS), adverse events (AEs) and re-operation. METHODOLOGY: Patients who underwent 
      a posterior cervical instrumented fusion (3 and + levels) with a C2 or C3 UIV, 
      with 24 months follow-up were analyzed. PROs (NDI, EQ5D, SF-12 PCS/MCS, NRS 
      arm/neck pain) were compared using ANCOVA. Operative duration, IOBL, AEs, and 
      re-operation were compared. Subgroup analysis was performed on patient presenting 
      with pre-operative malalignment (cervical sagittal vertical axis >/=40 mm and/or 
      T1slope- cervical lordosis >15 degrees ). RESULTS: 173 patients were included, of which 
      41 (24%) had a C2 UIV and 132 (76%) a C3 UIV. There was no statistically 
      significant difference between the groups for the changes in PROs up to 
      24 months. Subgroup analysis of patients with pre-operative malalignment showed a 
      trend towards greater improvement in the NDI at 12 months with a C2 UIV (P = 
      .054). Operative time, IOBL and peri-operative AEs were more in C2 group (P < 
      .05). There was no significant difference in LOS and re-operation (P > .05). 
      CONCLUSION: In this observational study, up to 24 months after surgery for 
      posterior cervical fusion in DCM greater than 3 levels, PROs appear to evolve 
      similarly.
FAU - Algarni, Nizar
AU  - Algarni N
AD  - Department of Orthopedic Surgery, College of Medicine, King Saud University, 
      Riyadh, Saudi Arabia. RINGGOLD: 48032
FAU - Dea, Nicolas
AU  - Dea N
AD  - Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopedics 
      Surgery, University of British Columbia, Vancouver BC, Canada. RINGGOLD: 8166
FAU - Evaniew, Nathan
AU  - Evaniew N
AUID- ORCID: 0000-0003-1974-5224
AD  - Combined Neurosurgical and Orthopedic Spine Program, University of Calgary, 
      Calgary, AB, Canada. RINGGOLD: 2129
FAU - McIntosh, Greg
AU  - McIntosh G
AUID- ORCID: 0000-0002-0268-6523
AD  - Canadian Spine Outcomes and Research Network, Markdale, ON, Canada.
FAU - Jacobs, Bradley W
AU  - Jacobs BW
AD  - Combined Neurosurgical and Orthopedic Spine Program, University of Calgary, 
      Calgary, AB, Canada. RINGGOLD: 2129
FAU - Paquet, Jerome
AU  - Paquet J
AUID- ORCID: 0000-0003-1390-2428
AD  - Centre de Recherche CHU de Quebec, CHU de Quebec-Universite Laval, Quebec City, 
      QC, Canada.
FAU - Wilson, Jefferson R
AU  - Wilson JR
AD  - Divisions of Orthopaedic and Neurosurgery, University of Toronto, Toronto, ON, 
      Canada. RINGGOLD: 7938
FAU - Hall, Hamilton
AU  - Hall H
AD  - Department of Surgery, University of Toronto, Toronto, ON, Canada. RINGGOLD: 7938
FAU - Bailey, Christopher S
AU  - Bailey CS
AD  - Department of Orthopedics Surgery, London Health Science Centre, Western 
      University, London, ON, Canada. RINGGOLD: 10033
FAU - Weber, Michael H
AU  - Weber MH
AD  - Department of Orthopedics Surgery, McGill UniversityHealth Centre, Montreal, QC, 
      Canada. RINGGOLD: 5620
FAU - Nataraj, Andrew
AU  - Nataraj A
AD  - Division of Neurosurgery, Department of Surgery, University of AlbertaHospital, 
      Edmonton, AB, Canada. RINGGOLD: 3158
FAU - Attabib, Najmedden
AU  - Attabib N
AD  - Canada East Spine Centre, Division of Neurosurgery, Horizon Health Network, Saint 
      John, NB, Canada.
FAU - Rampersaud, Y Raja
AU  - Rampersaud YR
AD  - Department of Surgery, University of Toronto, Toronto, ON, Canada. RINGGOLD: 7938
FAU - Cadotte, David W
AU  - Cadotte DW
AD  - Combined Neurosurgical and Orthopedic Spine Program, University of Calgary, 
      Calgary, AB, Canada. RINGGOLD: 2129
FAU - Stratton, Alexandra
AU  - Stratton A
AUID- ORCID: 0000-0002-9653-5514
AD  - Department of Orthopedics Surgery, The Ottawa Hospital, Ottawa, ON, Canada. 
      RINGGOLD: 27337
FAU - Christie, Sean D
AU  - Christie SD
AD  - Division of Neurosurgery, Dalhousie University, Halifax, NS, Canada. RINGGOLD: 
      12361
FAU - Fisher, Charles G
AU  - Fisher CG
AD  - Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopedics 
      Surgery, University of British Columbia, Vancouver BC, Canada. RINGGOLD: 8166
FAU - Charest-Morin, Raphaele
AU  - Charest-Morin R
AUID- ORCID: 0000-0002-7689-1087
AD  - Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopedics 
      Surgery, University of British Columbia, Vancouver BC, Canada. RINGGOLD: 8166
LA  - eng
PT  - Journal Article
DEP - 20230324
PL  - England
TA  - Global Spine J
JT  - Global spine journal
JID - 101596156
OTO - NOTNLM
OT  - C2
OT  - C3
OT  - Patient reported outcomes
OT  - cervical myelopathy
OT  - length of stay
OT  - posterior cervical spine surgery
OT  - upper instrumentation
OT  - upper instrumented vertebra
COIS- Declaration of conflicting interestsThe author(s) declared no potential conflicts 
      of interest with respect to the research, authorship, and/or publication of this 
      article.
EDAT- 2023/03/25 06:00
MHDA- 2023/03/25 06:00
CRDT- 2023/03/24 07:12
PHST- 2023/03/25 06:00 [pubmed]
PHST- 2023/03/25 06:00 [medline]
PHST- 2023/03/24 07:12 [entrez]
AID - 10.1177/21925682231166605 [doi]
PST - aheadofprint
SO  - Global Spine J. 2023 Mar 24:21925682231166605. doi: 10.1177/21925682231166605.