Cervical spondylotic myelopathy: conservative versus surgical
treatment after 10 years

J 2011

Cervical spondylotic myelopathy: conservative versus surgical treatment after 10 years

KADAŇKA, Zdeněk, Josef BEDNAŘÍK, Oldřich NOVOTNÝ, Igor URBÁNEK, Ladislav DUŠEK et. al.

Základní údaje

Originální název

Cervical spondylotic myelopathy: conservative versus surgical treatment after 10 years

Autoři

KADAŇKA, Zdeněk (203 Česká republika, garant, domácí), Josef BEDNAŘÍK (203 Česká republika), Oldřich NOVOTNÝ (203 Česká republika), Igor URBÁNEK (203 Česká republika) a Ladislav DUŠEK (203 Česká republika, domácí)

Vydání

European Spine Journal, Springer, 2011, 0940-6719

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30000 3. Medical and Health Sciences

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 1.965

Kód RIV

RIV/00216224:14740/11:00053467

Organizační jednotka

Středoevropský technologický institut

DOI

http://dx.doi.org/10.1007/s00586-011-1811-9

UT WoS

000294706700017

Klíčová slova anglicky

Spondylotic cervical myelopathy; Conservative treatment; Cervical spondylosis

Štítky

ok, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 25. 5. 2017 12:20, Mgr. Eva Špillingová

Anotace

V originále

It is not known whether the results of decompressive surgery to treat the mild and moderate forms of spondylotic cervical myelopathy (CSM) are any better than those of a conservative approach. A 10-year prospective randomised study was performed. The objective of the study was to compare conservative and operative treatments of mild and moderate, non-progressive, or slowly progressive, forms of CSM. Sixty-four patients were randomised into two groups of 32. Group A was treated conservatively while group B was treated surgically. The clinical outcome was evaluated by modified JOA score, timed 10-m walk, score of daily activities recorded by video and evaluated by two observers blinded to the type of therapy, and by subjective assessment by the patients themselves. Seventeen patents died of natural, unrelated causes, during the follow-up. A total of 25 patients in the conservatively and 22 in the surgically treated group were used for the final evaluation. There was no statistically significant difference between both groups in mJOA score, in subjective evaluation by the patients themselves and in evaluation of video-recordings of daily living activities by two observers blinded to treatment mode. There was neither any difference found in the percentage of patients losing the ability to walk nor in the time taken to cover the 10-m track from a standing start. Comparison of conservative and surgical treatment in mild and moderate forms of CSM in a 10-year follow-up has not shown, on average, a significant difference in results. In both groups, patients get better and worse. According to the power analysis it is necessary admit that these results possess the low ability to answer definitely the question which treatment is better for the patients with a mild and moderate non-progressive CSM because of the low number of patients for the final evaluation and for clinically negligible differences between two compared arms. These findings can serve as a worthy odds-on hypothesis which needs the confirmation.

Návaznosti

MSM0021622404, záměr

Název: Vnitřní organizace a neurobiologické mechanismy funkčních systémů CNS

Investor: Ministerstvo školství, mládeže a tělovýchovy ČR, Vnitřní organizace a neurobiologické mechanismy funkčních systémů CNS

Citovat

KADAŇKA, Zdeněk, Josef BEDNAŘÍK, Oldřich NOVOTNÝ, Igor URBÁNEK a Ladislav DUŠEK. Cervical spondylotic myelopathy: conservative versus surgical treatment after 10 years. European Spine Journal. Springer, 2011, roč. 20, č. 9, s. 1533-1538. ISSN 0940-6719. Dostupné z: https://dx.doi.org/10.1007/s00586-011-1811-9.

@article{953212,
   author = {Kadaňka, Zdeněk and Bednařík, Josef and Novotný, Oldřich and Urbánek, Igor and Dušek, Ladislav},
   article_number = {9},
   doi = {http://dx.doi.org/10.1007/s00586-011-1811-9},
   keywords = {Spondylotic cervical myelopathy; Conservative treatment; Cervical spondylosis},
   language = {eng},
   issn = {0940-6719},
   journal = {European Spine Journal},
   title = {Cervical spondylotic myelopathy: conservative versus surgical treatment after 10 years},
   volume = {20},
   year = {2011}
}

TY  - JOUR
ID  - 953212
AU  - Kadaňka, Zdeněk - Bednařík, Josef - Novotný, Oldřich - Urbánek, Igor - Dušek, Ladislav
PY  - 2011
TI  - Cervical spondylotic myelopathy: conservative versus surgical treatment after 10 years
JF  - European Spine Journal
VL  - 20
IS  - 9
SP  - 1533-1538
EP  - 1533-1538
PB  - Springer
SN  - 09406719
KW  - Spondylotic cervical myelopathy
KW  - Conservative treatment
KW  - Cervical spondylosis
N2  - It is not known whether the results of decompressive surgery to treat the mild and moderate forms of spondylotic cervical myelopathy (CSM) are any better than those of a conservative approach. A 10-year prospective randomised study was performed. The objective of the study was to compare conservative and operative treatments of mild and moderate, non-progressive, or slowly progressive, forms of CSM. Sixty-four patients were randomised into two groups of 32. Group A was treated conservatively while group B was treated surgically. The clinical outcome was evaluated by modified JOA score, timed 10-m walk, score of daily activities recorded by video and evaluated by two observers blinded to the type of therapy, and by subjective assessment by the patients themselves. Seventeen patents died of natural, unrelated causes, during the follow-up. A total of 25 patients in the conservatively and 22 in the surgically treated group were used for the final evaluation. There was no statistically significant difference between both groups in mJOA score, in subjective evaluation by the patients themselves and in evaluation of video-recordings of daily living activities by two observers blinded to treatment mode. There was neither any difference found in the percentage of patients losing the ability to walk nor in the time taken to cover the 10-m track from a standing start. Comparison of conservative and surgical treatment in mild and moderate forms of CSM in a 10-year follow-up has not shown, on average, a significant difference in results. In both groups, patients get better and worse. According to the power analysis it is necessary admit that these results possess the low ability to answer definitely the question which treatment is better for the patients with a mild and moderate non-progressive CSM because of the low number of patients for the final evaluation and for clinically negligible differences between two compared arms. These findings can serve as a worthy odds-on hypothesis which needs the confirmation.
ER  -

KADAŇKA, Zdeněk, Josef BEDNAŘÍK, Oldřich NOVOTNÝ, Igor URBÁNEK a Ladislav DUŠEK. Cervical spondylotic myelopathy: conservative versus surgical treatment after 10 years. \textit{European Spine Journal}. Springer, 2011, roč.~20, č.~9, s.~1533-1538. ISSN~0940-6719. Dostupné z: https://dx.doi.org/10.1007/s00586-011-1811-9.

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