The Relative Merits of Posterior Surgical Treatments for Multi-Level Degenerative Cervical Myelopathy Remain Uncertain: Findings from a Systematic Review
Objectives: To assess the reporting of study design and characteristics in multi-level degenerative cervical myelopathy (DCM) treated by posterior surgical approaches, and perform a comparison of clinical and radiographic outcomes between different approaches. Methods: A literature search was perfor...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-08-01
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| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/10/16/3653 |
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doaj-53e17a80a9064f53972fbfe6c509a79b |
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| record_format |
Article |
| collection |
DOAJ |
| language |
English |
| format |
Article |
| sources |
DOAJ |
| author |
Xiaoyu Yang Aref-Ali Gharooni Rana S. Dhillon Edward Goacher Edward W. Dyson Oliver Mowforth Alexandru Budu Guy Wynne-Jones Jibin Francis Rikin Trivedi Marcel Ivanov Sashin Ahuja Kia Rezajooi Andreas K. Demetriades David Choi Antony H. Bateman Nasir Quraishi Vishal Kumar Manjul Tripathi Sandeep Mohindra Erlick A. Pereira Giles Critchley Michael G. Fehlings Peter J. A. Hutchinson Benjamin M. Davies Mark R. N. Kotter |
| spellingShingle |
Xiaoyu Yang Aref-Ali Gharooni Rana S. Dhillon Edward Goacher Edward W. Dyson Oliver Mowforth Alexandru Budu Guy Wynne-Jones Jibin Francis Rikin Trivedi Marcel Ivanov Sashin Ahuja Kia Rezajooi Andreas K. Demetriades David Choi Antony H. Bateman Nasir Quraishi Vishal Kumar Manjul Tripathi Sandeep Mohindra Erlick A. Pereira Giles Critchley Michael G. Fehlings Peter J. A. Hutchinson Benjamin M. Davies Mark R. N. Kotter The Relative Merits of Posterior Surgical Treatments for Multi-Level Degenerative Cervical Myelopathy Remain Uncertain: Findings from a Systematic Review Journal of Clinical Medicine cervical spine multi-level myelopathy laminoplasty laminectomy fusion |
| author_facet |
Xiaoyu Yang Aref-Ali Gharooni Rana S. Dhillon Edward Goacher Edward W. Dyson Oliver Mowforth Alexandru Budu Guy Wynne-Jones Jibin Francis Rikin Trivedi Marcel Ivanov Sashin Ahuja Kia Rezajooi Andreas K. Demetriades David Choi Antony H. Bateman Nasir Quraishi Vishal Kumar Manjul Tripathi Sandeep Mohindra Erlick A. Pereira Giles Critchley Michael G. Fehlings Peter J. A. Hutchinson Benjamin M. Davies Mark R. N. Kotter |
| author_sort |
Xiaoyu Yang |
| title |
The Relative Merits of Posterior Surgical Treatments for Multi-Level Degenerative Cervical Myelopathy Remain Uncertain: Findings from a Systematic Review |
| title_short |
The Relative Merits of Posterior Surgical Treatments for Multi-Level Degenerative Cervical Myelopathy Remain Uncertain: Findings from a Systematic Review |
| title_full |
The Relative Merits of Posterior Surgical Treatments for Multi-Level Degenerative Cervical Myelopathy Remain Uncertain: Findings from a Systematic Review |
| title_fullStr |
The Relative Merits of Posterior Surgical Treatments for Multi-Level Degenerative Cervical Myelopathy Remain Uncertain: Findings from a Systematic Review |
| title_full_unstemmed |
The Relative Merits of Posterior Surgical Treatments for Multi-Level Degenerative Cervical Myelopathy Remain Uncertain: Findings from a Systematic Review |
| title_sort |
relative merits of posterior surgical treatments for multi-level degenerative cervical myelopathy remain uncertain: findings from a systematic review |
| publisher |
MDPI AG |
| series |
Journal of Clinical Medicine |
| issn |
2077-0383 |
| publishDate |
2021-08-01 |
| description |
Objectives: To assess the reporting of study design and characteristics in multi-level degenerative cervical myelopathy (DCM) treated by posterior surgical approaches, and perform a comparison of clinical and radiographic outcomes between different approaches. Methods: A literature search was performed in Embase and MEDLINE between 1995–2019 using a sensitive search string combination. Studies were selected by predefined selection criteria: Full text articles in English, with >10 patients (prospective) or >50 patients (retrospective), reporting outcomes of multi-level DCM treated by posterior surgical approach. Results: A total of 75 studies involving 19,510 patients, conducted worldwide, were identified. Laminoplasty was described in 56 studies (75%), followed by laminectomy with (36%) and without fusion (16%). The majority of studies were conducted in Asia (84%), in the period of 2016–2019 (51%), of which laminoplasty was studied predominantly. Twelve (16%) prospective studies and 63 (84%) retrospective studies were identified. The vast majority of studies were conducted in a single centre (95%) with clear inclusion/exclusion criteria and explicit cause of DCM. Eleven studies (15%) included patients with ossification of the posterior longitudinal ligament exclusively with cohorts of 57 to 252. The clinical and radiographic outcomes were reported with heterogeneity when comparing laminoplasty, laminectomy with and without fusion. Conclusions: Heterogeneity in the reporting of study and sample characteristics exists, as well as in clinical and radiographic outcomes, with a paucity of studies with a higher level of evidence. Future studies are needed to elucidate the clinical effectiveness of posterior surgical treatments. |
| topic |
cervical spine multi-level myelopathy laminoplasty laminectomy fusion |
| url |
https://www.mdpi.com/2077-0383/10/16/3653 |
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doaj-53e17a80a9064f53972fbfe6c509a79b2021-08-26T13:55:42ZengMDPI AGJournal of Clinical Medicine2077-03832021-08-01103653365310.3390/jcm10163653The Relative Merits of Posterior Surgical Treatments for Multi-Level Degenerative Cervical Myelopathy Remain Uncertain: Findings from a Systematic ReviewXiaoyu Yang0Aref-Ali Gharooni1Rana S. Dhillon2Edward Goacher3Edward W. Dyson4Oliver Mowforth5Alexandru Budu6Guy Wynne-Jones7Jibin Francis8Rikin Trivedi9Marcel Ivanov10Sashin Ahuja11Kia Rezajooi12Andreas K. Demetriades13David Choi14Antony H. Bateman15Nasir Quraishi16Vishal Kumar17Manjul Tripathi18Sandeep Mohindra19Erlick A. Pereira20Giles Critchley21Michael G. Fehlings22Peter J. A. Hutchinson23Benjamin M. Davies24Mark R. N. Kotter25Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB0 0GG, UKDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB0 0GG, UKDepartment of Neurosurgery, St Vincent’s Hospital Melbourne, Melbourne, VIC 3065, AustraliaDepartment of Neurosurgery, Royal Hallamshire Hospital, Sheffield S10 2JF, UKVictor Horsley Department of Neurosurgery, National Hospital for Neurology & Neurosurgery, London WC1N 3BG, UKDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB0 0GG, UKDepartment of Neurosurgery, Sheffield Teaching Hospitals National Health Service Foundation Trust, Sheffield S10 2JF, UKDepartment of Orthopaedics, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UKDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB0 0GG, UKDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB0 0GG, UKDepartment of Neurosurgery, Sheffield Teaching Hospitals National Health Service Foundation Trust, Sheffield S10 2JF, UKWelsh Centre for Spinal Surgery & Trauma, University hospital of Wales, Cardiff CF14 4XW, UKSpinal Surgery Unit, Royal National Orthopaedic Hospital, Stanmore HA7 4LP, UKEdinburgh Spinal Surgery Outcome Studies Group, Department of Neurosurgery, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UKDepartment of Neurosurgery, National Hospital for Neurology and Neurosurgery, University College London Hospitals, London WC1N 3BG, UKRoyal Derby Spinal Centre, Royal Derby Hospital, Derby DE22 3NE, UKNottingham Centre for Spinal Studies and Surgery, Queens Medical Centre, Nottingham University Hospitals, Nottingham NG7 2UH, UKDepartment of Orthopaedics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, IndiaDepartment of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, IndiaDepartment of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, IndiaNeurosciences Research Centre, Institute of Molecular and Clinical Sciences, St George’s, University of London, London WC1E 7HU, UKBrighton and Sussex Medical School, South East Neurosurgery and South East Spinal Surgery, University Hospitals Sussex NHS Foundation Trust, Brighton BN1 9PX, UKDivision of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, ON M5T 2S8, CanadaDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB0 0GG, UKDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB0 0GG, UKDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB0 0GG, UKObjectives: To assess the reporting of study design and characteristics in multi-level degenerative cervical myelopathy (DCM) treated by posterior surgical approaches, and perform a comparison of clinical and radiographic outcomes between different approaches. Methods: A literature search was performed in Embase and MEDLINE between 1995–2019 using a sensitive search string combination. Studies were selected by predefined selection criteria: Full text articles in English, with >10 patients (prospective) or >50 patients (retrospective), reporting outcomes of multi-level DCM treated by posterior surgical approach. Results: A total of 75 studies involving 19,510 patients, conducted worldwide, were identified. Laminoplasty was described in 56 studies (75%), followed by laminectomy with (36%) and without fusion (16%). The majority of studies were conducted in Asia (84%), in the period of 2016–2019 (51%), of which laminoplasty was studied predominantly. Twelve (16%) prospective studies and 63 (84%) retrospective studies were identified. The vast majority of studies were conducted in a single centre (95%) with clear inclusion/exclusion criteria and explicit cause of DCM. Eleven studies (15%) included patients with ossification of the posterior longitudinal ligament exclusively with cohorts of 57 to 252. The clinical and radiographic outcomes were reported with heterogeneity when comparing laminoplasty, laminectomy with and without fusion. Conclusions: Heterogeneity in the reporting of study and sample characteristics exists, as well as in clinical and radiographic outcomes, with a paucity of studies with a higher level of evidence. Future studies are needed to elucidate the clinical effectiveness of posterior surgical treatments.https://www.mdpi.com/2077-0383/10/16/3653cervical spinemulti-levelmyelopathylaminoplastylaminectomyfusion |