Nancy E Epstein1. 1. Albert Einstein College of Medicine, Bronx, NY, USA.
Abstract
STUDY DESIGN: Three outcome measures, Nurick grades, Odom's criteria, and the Short Form (SF-36) were analyzed following circumferential cervical surgery in 47 patients. OBJECTIVES: To analyze three outcome measures following circumferential surgery. SUMMARY OF BACKGROUND DATA: Few studies use multiple outcome criteria to assess circumferential surgery. METHODS: Patients averaged 54 years of age and exhibited severe myelopathy (Nurick grade 3.6). Corpectomies of 2.6 vertebrae (on average) were followed by posterior fusions (C2-T1) with halo stabilization. Initial fixed-plates (n = 28) and subsequent dynamic ABC plates (Aesculap, Tuttlingen, Germany) (n = 19) were applied, Fusion was confirmed on dynamic radiographs and two-dimensional CT studies 3, 6, and up to 12 months after surgery. Nurick grades and Odom's criteria were evaluated 1 and 2 years after surgery. Results of SF-36 questionnaires, obtained before surgery, 6 weeks, 3 months, 6 months, 1 year, 2 years after surgery, were calculated. RESULTS: Neurodiagnostic studies confirmed fusion on average 5.0 months after surgery. One and 2 years after surgery, mean Nurick grades were 0.8 (+2.8 points) and 0.4 (+3.2 points), respectively. One year (2 years) postoperative Odom's criteria revealed excellent 26 (30), good 14 (11), fair 6 (5), and poor 1 (1) patient outcomes. Comparing preoperative with 1-year postoperative SF-36 questionnaires revealed moderate improvement on 5 health scales: Social Function (+19.9), Bodily Pain (+19.6), Role-Physical (+18.8), Physical Function (+12.5), and Role-Emotional (+11.1). Minimal additional improvement occurred over the second year: Role-Physical (+21.6), Social Function (+16.4), Bodily Pain (+13.4), Physical Function (+12.8), and Role Emotional (+9.5). CONCLUSION: Based on three outcome measures, the greatest improvement occurs 1 year following circumferential surgery.
STUDY DESIGN: Three outcome measures, Nurick grades, Odom's criteria, and the Short Form (SF-36) were analyzed following circumferential cervical surgery in 47 patients. OBJECTIVES: To analyze three outcome measures following circumferential surgery. SUMMARY OF BACKGROUND DATA: Few studies use multiple outcome criteria to assess circumferential surgery. METHODS:Patients averaged 54 years of age and exhibited severe myelopathy (Nurick grade 3.6). Corpectomies of 2.6 vertebrae (on average) were followed by posterior fusions (C2-T1) with halo stabilization. Initial fixed-plates (n = 28) and subsequent dynamic ABC plates (Aesculap, Tuttlingen, Germany) (n = 19) were applied, Fusion was confirmed on dynamic radiographs and two-dimensional CT studies 3, 6, and up to 12 months after surgery. Nurick grades and Odom's criteria were evaluated 1 and 2 years after surgery. Results of SF-36 questionnaires, obtained before surgery, 6 weeks, 3 months, 6 months, 1 year, 2 years after surgery, were calculated. RESULTS: Neurodiagnostic studies confirmed fusion on average 5.0 months after surgery. One and 2 years after surgery, mean Nurick grades were 0.8 (+2.8 points) and 0.4 (+3.2 points), respectively. One year (2 years) postoperative Odom's criteria revealed excellent 26 (30), good 14 (11), fair 6 (5), and poor 1 (1) patient outcomes. Comparing preoperative with 1-year postoperative SF-36 questionnaires revealed moderate improvement on 5 health scales: Social Function (+19.9), Bodily Pain (+19.6), Role-Physical (+18.8), Physical Function (+12.5), and Role-Emotional (+11.1). Minimal additional improvement occurred over the second year: Role-Physical (+21.6), Social Function (+16.4), Bodily Pain (+13.4), Physical Function (+12.8), and Role Emotional (+9.5). CONCLUSION: Based on three outcome measures, the greatest improvement occurs 1 year following circumferential surgery.