PMID- 37463661
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231105
IS  - 1976-1902 (Print)
IS  - 1976-7846 (Electronic)
IS  - 1976-1902 (Linking)
VI  - 17
IP  - 5
DP  - 2023 Oct
TI  - Clinicoradiological Risk Factors Associated with Inability to Achieve Minimum 
      Clinically Important Difference in Operated Cases of Cervical Spondylotic 
      Myelopathy.
PG  - 904-915
LID - 10.31616/asj.2022.0446 [doi]
AB  - STUDY DESIGN: This is a retrospective cohort study. PURPOSE: This study aimed to 
      identify the clinicoradiological risk factors associated with the inability to 
      achieve minimum clinically important difference (MCID) on the modified Japanese 
      Orthopaedic Association (mJOA) Scale in operated cases of cervical spondylotic 
      myelopathy (CSM). OVERVIEW OF LITERATURE: Only a few studies have evaluated the 
      outcomes of surgery performed for CSM using MCID on the mJOA scale. METHODS: We 
      analyzed 124 operated CSM cases from March 2019 to April 2021 for preoperative 
      clinical features, cervical sagittal radiographic parameters, and magnetic 
      resonance imaging (MRI) signal intensities (SI). The risk factors associated with 
      missing the MCID (poor outcome) on mJOA at the final follow-up were identified 
      using binary logistic regression. Multivariate analysis was used to find 
      significant risk factors, and odds ratios (OR) were computed. RESULTS: A total of 
      110 men (89.2%) and 14 women (10.8%) with an average age of 53.5+/-13.2 years were 
      included in the analysis. During the last follow-up, 89 cases (72.1%) achieved 
      MCID (meaningful gains following surgery) while 35 (27.9%) could not. The final 
      model identified the following parameters as significant risk factors for poor 
      outcome: increased duration of symptoms (OR, 6.77; p=0.001), lower preoperative 
      mJOA scale (OR, 0.75; p=0.029), the presence of multilevel T2-weighted (T2W) MRI 
      SI (OR, 4.79; p=0.004), and larger change in cervical sagittal vertical axis 
      (DeltacSVA) (OR, 1.06; p=0.013). Also, an increase in cSVA postoperatively correlated 
      with a reduced functional recovery rate (r=-0.4, p<0.001). CONCLUSIONS: Surgery 
      for CSM leads to significant functional benefits. However, poorer outcomes are 
      observed in cases of greater duration of symptoms, higher preoperative severity 
      with multilevel T2W MRI SI, and a larger increase in the postoperative cSVA 
      (sagittal imbalance).
FAU - Acharya, Shankar
AU  - Acharya S
AD  - Department of Ortho-Spine Surgery, Sir Ganga Ram Hospital, New Delhi, India.
FAU - Khanna, Varun
AU  - Khanna V
AD  - Department of Ortho-Spine Surgery, Sir Ganga Ram Hospital, New Delhi, India.
FAU - Chahal, Rupinder Singh
AU  - Chahal RS
AD  - Department of Ortho-Spine Surgery, Sir Ganga Ram Hospital, New Delhi, India.
FAU - Kalra, Kashmiri Lal
AU  - Kalra KL
AD  - Department of Ortho-Spine Surgery, Sir Ganga Ram Hospital, New Delhi, India.
FAU - Vishwakarma, Gayatri
AU  - Vishwakarma G
AD  - The George Institute for Global Health, New Delhi, India.
LA  - eng
PT  - Journal Article
DEP - 20230719
PL  - Korea (South)
TA  - Asian Spine J
JT  - Asian spine journal
JID - 101314177
PMC - PMC10622822
OTO - NOTNLM
OT  - Cervical cord
OT  - Cervical sagittal alignment
OT  - Compressive myelopathy
OT  - Minimal clinically important improvement
OT  - Minimum clinically important difference
OT  - Neck
OT  - Risk factor
COIS- Conflict of Interest No potential conflict of interest relevant to this article 
      was reported.
EDAT- 2023/07/19 01:06
MHDA- 2023/07/19 01:07
PMCR- 2023/10/01
CRDT- 2023/07/18 19:21
PHST- 2023/12/20 00:00 [received]
PHST- 2023/05/27 00:00 [accepted]
PHST- 2023/07/19 01:07 [medline]
PHST- 2023/07/19 01:06 [pubmed]
PHST- 2023/07/18 19:21 [entrez]
PHST- 2023/10/01 00:00 [pmc-release]
AID - asj.2022.0446 [pii]
AID - asj-2022-0446 [pii]
AID - 10.31616/asj.2022.0446 [doi]
PST - ppublish
SO  - Asian Spine J. 2023 Oct;17(5):904-915. doi: 10.31616/asj.2022.0446. Epub 2023 Jul 
      19.