A Controlled Single-Centre Pilot Study to Evaluate the Effect
of Prophylactic Surgery in Asymptomatic Degenerative Cervical
Cord Compression

J 2025

A Controlled Single-Centre Pilot Study to Evaluate the Effect of Prophylactic Surgery in Asymptomatic Degenerative Cervical Cord Compression

KADAŇKA, Zdeněk, Martin NEMEC, Richard CHALOUPKA, Luděk RYBA, Karel MÁCA et. al.

Basic information

Original name

A Controlled Single-Centre Pilot Study to Evaluate the Effect of Prophylactic Surgery in Asymptomatic Degenerative Cervical Cord Compression

Authors

Edition

GLOBAL SPINE JOURNAL, LONDON, SAGE PUBLICATIONS LTD, 2025, 2192-5682

Other information

Language

English

Type of outcome

Article in a journal

Field of Study

30210 Clinical neurology

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

is not subject to a state or trade secret

References:

URL

Impact factor

Impact factor: 2.600 in 2023

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1177/21925682251323862

UT WoS

001444677000001

EID Scopus

2-s2.0-105000412500

Keywords in English

asymptomatic degenerative cervical cord compression; degenerative cervical myelopathy; prophylactic surgery

Abstract

V originále

Study Design Single-centre controlled pilot study.Objectives To evaluate the effect of prophylactic surgery and to review the biases of a therapeutic trial in asymptomatic degenerative cervical cord compression (ADCC) patients.Methods Patients with ADCC and at least 1 predictor of progression to symptomatic degenerative cervical cord myelopathy (DCM) were offered either prophylactic surgery or standard structured rehabilitation. Recruited patients were clinically followed to detect the development of symptomatic DCM.Results Forty-one patients treated surgically and 68 patients treated non-surgically completed the minimum 36 months' follow-up; 3 recruited patients were lost from evaluation. The surgical group had a higher Neck Disability Index score and more severe MRI compression. A matched subgroup of 41 non-surgical patients was created to reduce potential bias. During the follow-up period we observed progression to symptomatic DCM in 1 surgical case (2.4%) compared to 9 patients in the non-surgical group (13.2%, P = 0.054) and 7 cases in the matched non-surgical group (17.1%, P = 0.029). We observed non-serious early postoperative complications in 4 patients, which resolved spontaneously or after surgical revision. In 9 patients with progression to DCM, the myelopathy was mild with mJOA scale 15-17. One patient in the non-surgical group and 1 patient in the surgical group who progressed to DCM underwent surgery with a good outcome.Conclusions Prophylactic surgery led to a significant decrease in proportion of ADCC patients with progression to DCM. The results justify the organisation of a large randomized multicentre trial that may demonstrate the benefit of prophylactic surgery in ADCC patients.

Links

NU22-04-00024, research and development project

Name: Kvantitativní zobrazovací MR parametry jako prediktory průběhu nemyelopatické degenerativní komprese krční míchy: longitudinální studie

Investor: Ministry of Health of the CR, Quantitative magnetic resonance imaging parameters as predictors of outcome of non-myelopathic degenerative cervical cord compression: a longitudinal study, Subprogram 1 - standard

NV18-04-00159, research and development project

Name: Využití pokročilých magneticko-rezonančních technik k odhalení patofyziologie a zlepšení diagnostiky a praktického managementu degenerativní komprese krční míchy

Investor: Ministry of Health of the CR

Cite

KADAŇKA, Zdeněk, Martin NEMEC, Richard CHALOUPKA, Luděk RYBA, Karel MÁCA, Dušan MATEJIČKA, Tomáš ROHAN, Miloš KEŘKOVSKÝ, Tomáš HORÁK, Magda HORÁKOVÁ, Eva VLČKOVÁ and Josef BEDNAŘÍK. A Controlled Single-Centre Pilot Study to Evaluate the Effect of Prophylactic Surgery in Asymptomatic Degenerative Cervical Cord Compression. GLOBAL SPINE JOURNAL. LONDON: SAGE PUBLICATIONS LTD, 2025, 9 pp. ISSN 2192-5682. Available from: https://dx.doi.org/10.1177/21925682251323862.

@article{2488519,
   author = {Kadaňka, Zdeněk and Nemec, Martin and Chaloupka, Richard and Ryba, Luděk and Máca, Karel and Matejička, Dušan and Rohan, Tomáš and Keřkovský, Miloš and Horák, Tomáš and Horáková, Magda and Vlčková, Eva and Bednařík, Josef},
   article_location = {LONDON},
   doi = {http://dx.doi.org/10.1177/21925682251323862},
   keywords = {asymptomatic degenerative cervical cord compression; degenerative cervical myelopathy; prophylactic surgery},
   language = {eng},
   issn = {2192-5682},
   journal = {GLOBAL SPINE JOURNAL},
   title = {A Controlled Single-Centre Pilot Study to Evaluate the Effect of Prophylactic Surgery in Asymptomatic Degenerative Cervical Cord Compression},
   url = {https://journals.sagepub.com/doi/10.1177/21925682251323862},
   year = {2025}
}

TY  - JOUR
ID  - 2488519
AU  - Kadaňka, Zdeněk - Nemec, Martin - Chaloupka, Richard - Ryba, Luděk - Máca, Karel - Matejička, Dušan - Rohan, Tomáš - Keřkovský, Miloš - Horák, Tomáš - Horáková, Magda - Vlčková, Eva - Bednařík, Josef
PY  - 2025
TI  - A Controlled Single-Centre Pilot Study to Evaluate the Effect of Prophylactic Surgery in Asymptomatic Degenerative Cervical Cord Compression
JF  - GLOBAL SPINE JOURNAL
PB  - SAGE PUBLICATIONS LTD
SN  - 21925682
KW  - asymptomatic degenerative cervical cord compression
KW  - degenerative cervical myelopathy
KW  - prophylactic surgery
UR  - https://journals.sagepub.com/doi/10.1177/21925682251323862
N2  - Study Design Single-centre controlled pilot study.Objectives To evaluate the effect of prophylactic surgery and to review the biases of a therapeutic trial in asymptomatic degenerative cervical cord compression (ADCC) patients.Methods Patients with ADCC and at least 1 predictor of progression to symptomatic degenerative cervical cord myelopathy (DCM) were offered either prophylactic surgery or standard structured rehabilitation. Recruited patients were clinically followed to detect the development of symptomatic DCM.Results Forty-one patients treated surgically and 68 patients treated non-surgically completed the minimum 36 months' follow-up; 3 recruited patients were lost from evaluation. The surgical group had a higher Neck Disability Index score and more severe MRI compression. A matched subgroup of 41 non-surgical patients was created to reduce potential bias. During the follow-up period we observed progression to symptomatic DCM in 1 surgical case (2.4%) compared to 9 patients in the non-surgical group (13.2%, P = 0.054) and 7 cases in the matched non-surgical group (17.1%, P = 0.029). We observed non-serious early postoperative complications in 4 patients, which resolved spontaneously or after surgical revision. In 9 patients with progression to DCM, the myelopathy was mild with mJOA scale 15-17. One patient in the non-surgical group and 1 patient in the surgical group who progressed to DCM underwent surgery with a good outcome.Conclusions Prophylactic surgery led to a significant decrease in proportion of ADCC patients with progression to DCM. The results justify the organisation of a large randomized multicentre trial that may demonstrate the benefit of prophylactic surgery in ADCC patients.
ER  -

KADAŇKA, Zdeněk, Martin NEMEC, Richard CHALOUPKA, Luděk RYBA, Karel MÁCA, Dušan MATEJIČKA, Tomáš ROHAN, Miloš KEŘKOVSKÝ, Tomáš HORÁK, Magda HORÁKOVÁ, Eva VLČKOVÁ and Josef BEDNAŘÍK. A Controlled Single-Centre Pilot Study to Evaluate the Effect of Prophylactic Surgery in Asymptomatic Degenerative Cervical Cord Compression. \textit{GLOBAL SPINE JOURNAL}. LONDON: SAGE PUBLICATIONS LTD, 2025, 9 pp. ISSN~2192-5682. Available from: https://dx.doi.org/10.1177/21925682251323862.

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