Siril T Holmberg1,2, Agnete M Gulati3, Tonje Okkenhaug Johansen4,5, Øyvind O Salvesen6, Vetle Vangen Lønne4,5, Tore K Solberg7,8, Erling A Tronvik5,9, Øystein P Nygaard4,5,10, Sasha Gulati4,5,10. 1. Department of Neurosurgery, St. Olavs Hospital, 7006, Trondheim, Norway. sirilthe@stud.ntnu.no. 2. Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway. sirilthe@stud.ntnu.no. 3. Department of Rheumatology, St. Olavs Hospital, Trondheim, Norway. 4. Department of Neurosurgery, St. Olavs Hospital, 7006, Trondheim, Norway. 5. Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway. 6. Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway. 7. Department of Neurosurgery and the Norwegian Registry for Spine Surgery, University Hospital of North Norway, Tromsø, Norway. 8. Institute for Clinical Medicine, The Arctic University of Norway, Tromsø, Norway. 9. Norwegian Advisory Unit On Headaches, St. Olavs University Hospital, Trondheim, Norway. 10. National Advisory Unit On Spinal Surgery, St. Olavs Hospital, Trondheim, Norway.
Abstract
PURPOSE: To compare patient-reported outcomes (PROMs) following surgery for degenerative cervical myelopathy (DCM) among patients with rheumatoid arthritis (RA) or ankylosing spondylitis (AS) versus those without rheumatic diseases. METHODS: Data were obtained from the Norwegian Registry for Spine Surgery. The primary outcome was change in the Neck Disability Index (NDI) at 1 year. Secondary endpoints included the European Myelopathy Score (EMS), quality of life (EuroQoL-5D [EQ-5D]), numeric rating scales (NRS) for headache, neck pain, and arm pain, and complications. RESULTS: Among 905 participants operated between 2012 and 2018, 35 had RA or AS. There were significant improvements in all PROMs at 1 year and no statistically significant difference between the cohorts in mean change in NDI (- 0.64, 95% CI - 8.1 to 6.8, P = .372), EQ-5D (0.10, 95% CI - 0.04 to 0.24, P = .168), NRS neck pain (- 0.8, 95% CI - 2.0 to 0.4, P = .210), NRS arm pain (- 0.6, 95% CI - 1.9 to 0.7, P = .351), and NRS headache (- 0.5, 95% CI - 1.7 to 0.8, P = .460). DISCUSSION AND CONCLUSION: Our study adds to the limited available evidence that surgical treatment cannot only arrest further progression of myelopathy but also improve functional status, neurological outcomes, and quality of life in patients with rheumatic disease.
PURPOSE: To compare patient-reported outcomes (PROMs) following surgery for degenerative cervical myelopathy (DCM) among patients with rheumatoid arthritis (RA) or ankylosing spondylitis (AS) versus those without rheumatic diseases. METHODS: Data were obtained from the Norwegian Registry for Spine Surgery. The primary outcome was change in the Neck Disability Index (NDI) at 1 year. Secondary endpoints included the European Myelopathy Score (EMS), quality of life (EuroQoL-5D [EQ-5D]), numeric rating scales (NRS) for headache, neck pain, and arm pain, and complications. RESULTS: Among 905 participants operated between 2012 and 2018, 35 had RA or AS. There were significant improvements in all PROMs at 1 year and no statistically significant difference between the cohorts in mean change in NDI (- 0.64, 95% CI - 8.1 to 6.8, P = .372), EQ-5D (0.10, 95% CI - 0.04 to 0.24, P = .168), NRS neck pain (- 0.8, 95% CI - 2.0 to 0.4, P = .210), NRS arm pain (- 0.6, 95% CI - 1.9 to 0.7, P = .351), and NRS headache (- 0.5, 95% CI - 1.7 to 0.8, P = .460). DISCUSSION AND CONCLUSION: Our study adds to the limited available evidence that surgical treatment cannot only arrest further progression of myelopathy but also improve functional status, neurological outcomes, and quality of life in patients with rheumatic disease.
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