Benjamin M Davies1, Jibin J Francis2, Max B Butler3, Oliver Mowforth3, Edward Goacher4, Michelle Starkey3, Angelos Kolias2, Guy Wynne-Jones4, Mike Hutton5, Senthil Selvanathan6, Simon Thomson6, Rodney J C Laing2, Peter J Hutchinson2, Mark R N Kotter7. 1. Division of Neurosurgery, Addenbrooke's Hospital and University of Cambridge, Cambridge, United Kingdom. Electronic address: bd375@cam.ac.uk. 2. Division of Neurosurgery, Addenbrooke's Hospital and University of Cambridge, Cambridge, United Kingdom. 3. Academic Neurosurgery Unit, Department of Clinical Neurosurgery, University of Cambridge, Cambridge, United Kingdom. 4. Department of Musculoskeletal, Spinal Unit, Royal Victoria Infirmary, Newcastle, United Kingdom. 5. Royal Devon and Exeter Hospital, United Kingdom. 6. Leeds Teaching Hospitals NHS Trust, United Kingdom. 7. Division of Neurosurgery, Addenbrooke's Hospital and University of Cambridge, Cambridge, United Kingdom; Department of Neurosurgery, Royal Hallamshire Hospital, Sheffield, United Kingdom.
Abstract
Degenerative cervical myelopathy (DCM) results from compression of the cervical spine cord as a result of age related changes in the cervical spine, and affects up to 2% of adults, leading to progressive disability. Surgical decompression is the mainstay of treatment, but there remains significant variation in surgical approaches used. This survey was conducted in order to define current practice amongst spine surgeons worldwide, as a possible prelude to further studies comparing surgical approaches. METHODS: An electronic survey was developed and piloted by the investigators using SurveyMonkey. Collected data was categorical and is presented using summary statistics. Where applicable, statistical comparisons were made using a Chi-Squared test. The level of significance for all statistical analyses was defined as p < 0.05. All analysis, including graphs was performed using R (R Studio). RESULTS: 127 surgeons, from 30 countries completed the survey; principally UK (66, 52%) and North America (15, 12%). Respondents were predominantly Neurosurgeons by training (108, 85%) of whom 84 (75%) reported Spinal Surgery as the principal part of their practice. The majority indicated they selected their surgical procedure for multi-level DCM on a case by case basis (62, 49%). Overall, a posterior approach was more popular for multi-level DCM (74, 58%). Region, speciality or annual multi-level case load did not influence this significantly. However, there was a trend for North American surgeons to be more likely to favour a posterior approach. CONCLUSIONS: A posterior approach was favoured and more commonly used to treat multi-level DCM, in an international cohort of surgeons. Posterior techniques including laminectomy, laminectomy and fusion or laminoplasty appeared to be equally popular.
Degenerative cervical myelopathy (DCM) results from compression of the cervical spine cord as a result of age related changes in the cervical spine, and affects up to 2% of adults, leading to progressive disability. Surgical decompression is the mainstay of treatment, but there remains significant variation in surgical approaches used. This survey was conducted in order to define current practice amongst spine surgeons worldwide, as a possible prelude to further studies comparing surgical approaches. METHODS: An electronic survey was developed and piloted by the investigators using SurveyMonkey. Collected data was categorical and is presented using summary statistics. Where applicable, statistical comparisons were made using a Chi-Squared test. The level of significance for all statistical analyses was defined as p < 0.05. All analysis, including graphs was performed using R (R Studio). RESULTS: 127 surgeons, from 30 countries completed the survey; principally UK (66, 52%) and North America (15, 12%). Respondents were predominantly Neurosurgeons by training (108, 85%) of whom 84 (75%) reported Spinal Surgery as the principal part of their practice. The majority indicated they selected their surgical procedure for multi-level DCM on a case by case basis (62, 49%). Overall, a posterior approach was more popular for multi-level DCM (74, 58%). Region, speciality or annual multi-level case load did not influence this significantly. However, there was a trend for North American surgeons to be more likely to favour a posterior approach. CONCLUSIONS: A posterior approach was favoured and more commonly used to treat multi-level DCM, in an international cohort of surgeons. Posterior techniques including laminectomy, laminectomy and fusion or laminoplasty appeared to be equally popular.
Authors: Edward Goacher; Richard Phillips; Oliver D Mowforth; Stefan Yordanov; Erlick A C Pereira; Adrian Gardner; Nasir A Quraishi; Antony H Bateman; Andreas K Demetriades; Marcel Ivanov; Alexandru Budu; Edward Dyson; Guy Wynne-Jones; Benjamin M Davies; Mark R N Kotter Journal: Acta Neurochir (Wien) Date: 2022-05-05 Impact factor: 2.816