Division of Neurosurgery, Addenbrooke's Hospital and University of Cambridge, Cambridge, United Kingdom.
Division of Neurosurgery, Addenbrooke's Hospital and University of Cambridge, Cambridge, United Kingdom.
J Clin Neurosci. 2021 May;87:84-88. doi: 10.1016/j.jocn.2021.01.049. Epub 2021 Mar 17.
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.
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).
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.
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.
退行性颈椎脊髓病（DCM）是由于颈椎的年龄相关变化导致颈椎脊髓受压而引起的，影响多达 2%的成年人，导致进行性残疾。手术减压是主要的治疗方法，但手术方法仍存在很大差异。这项调查旨在确定全球脊柱外科医生的当前实践，作为进一步比较手术方法的研究的前奏。
调查人员使用 SurveyMonkey 开发并试点了电子调查。收集的数据是分类的，并使用摘要统计数据呈现。在适用的情况下，使用卡方检验进行统计比较。所有统计分析的显著性水平定义为 p<0.05。所有分析，包括图形，均使用 R（R Studio）进行。
来自 30 个国家的 127 名外科医生完成了调查；主要来自英国（66，52%）和北美（15，12%）。受访者主要是神经外科医生（108，85%），其中 84 名（75%）报告脊柱手术是其主要实践部分。大多数人表示，他们根据具体情况选择多节段 DCM 的手术程序（62，49%）。总体而言，后路方法更常用于多节段 DCM（74，58%）。地区、专业或每年的多节段病例量并没有显著影响这一点。然而，北美外科医生更倾向于选择后路的趋势。
在后路方法中，更受欢迎，并更常用于治疗多节段 DCM，在国际外科医生队列中。后路技术，包括椎板切除术、椎板切除术和融合或椎板成形术，似乎同样受欢迎。
