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Predictors of Outcome After Surgical Decompression for mild degenerative Cervical Myelopathy -A Systematic Review.
Khosravi, Sepehr; Farahbakhsh, Farzin; Hesari, Marjan; Shahmohammadi, Alireza; Aliakbargolkar, Alireza; Baigi, Vali; Eskandari, Zahra; Ghodsi, Zahra; Harrop, James; Rahimi-Movaghar, Vafa; Ghodsi, Seyed Mohammad.
Afiliação
  • Khosravi S; Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Farahbakhsh F; Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
  • Hesari M; Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Shahmohammadi A; Tabriz University of Medical Science, Tabriz, Iran.
  • Aliakbargolkar A; Iran University of Medical Sciences, Tehran, Iran.
  • Baigi V; Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Eskandari Z; Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Ghodsi Z; Department of Management, Faculty of Social Sciences and Economics, Alzahra University, Tehran, Iran.
  • Harrop J; Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Rahimi-Movaghar V; Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
  • Ghodsi SM; Department of Neurological and Orthopedic Surgery Chief, Division of Spine and Peripheral Nerve Surgery Director, Enterprise Neuroscience Quality and Safety Neurosurgery Director of Delaware Valley SCI Center, Thomas Jefferson University, Philadelphia, PA, USA.
Global Spine J ; 14(2): 697-706, 2024 Mar.
Article em En | MEDLINE | ID: mdl-36912895
ABSTRACT
STUDY

DESIGN:

Systematic Reviews.

OBJECTIVES:

To investigate predictors of surgical outcomes for mild Degenerative Cervical Myelopathy (DCM) by reviewing all related studies conducted at this point.

METHODS:

An electronic search was carried out in PubMed, EMBASE, Scopus, and Web of Science until June 23, 2021. Full-text articles reporting surgical outcome predictors of mild DCM cases were eligible. We included studies with mild DCM which was defined as a modified Japanese Orthopaedic Association score of 15 to 17 or a Japanese Orthopaedic Association score of 13 to 16. Independent reviewers screened all the records, and discrepancies between the reviewers were solved in a session with the senior author. For risk of bias assessment, RoB 2 tool was used for randomized clinical trials and ROBINS-I for non-randomized studies.

RESULTS:

After screening 6 087 manuscripts, only 8 studies met the inclusion criteria. Lower pre-operative mJOA scores and quality-of-life measurement scores were reported by multiple studies to predict better surgical outcomes compared to other groups. High-intensity pre-operative T2 magnetic resonance imaging (MRI) was also reported to predict poor outcomes. Neck pain before intervention resulted in improved patient-reported outcomes. Two studies also reported motor symptoms prior to surgery as outcome predictors.

CONCLUSION:

Lower quality of life before surgery, neck pain, lower pre-operative mJOA scores, motor symptoms before surgery, female gender, gastrointestinal comorbidities, surgical procedure and surgeon's experience with specific techniques, and high signal intensity of cord in T2 MRI were the surgical outcome predictors reported in the literature. Lower Quality of Life (QoL) score and neck prior to surgery were reported as predictors of the more improved outcome, but high cord signal intensity in T2 MRI was reported as an unfavorable outcome predictor.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Prognostic_studies / Risk_factors_studies / Systematic_reviews Idioma: En Revista: Global Spine J Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Irã

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Prognostic_studies / Risk_factors_studies / Systematic_reviews Idioma: En Revista: Global Spine J Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Irã