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澳大利亚退行性颈椎脊髓病患者的基线特征:来自脊髓病自然史登记处的分析。

Baseline characteristics of patients with degenerative cervical myelopathy in Australia: analysis from the MYelopathy NAtural History registry.

作者信息

Najib Nashwa, Yataganbaba Alper, Briggs Nancy E, Ghahreman Ali, Mobbs Ralph, Rao Prashant J, Hansen Mitchell, Davies Mark, Kohan Saeed, Kulkarni Vinay, Sial Alisha, Ambikaipalan Anuruthran, Diwan Ashish D

机构信息

University of New South Wales (UNSW), Sydney, Australia.

Royal Melbourne Hospital, Melbourne, Australia.

出版信息

ANZ J Surg. 2025 May;95(5):979-984. doi: 10.1111/ans.19354. Epub 2024 Dec 17.

Abstract

BACKGROUND

Degenerative Cervical Myelopathy (DCM) is the most common cause of non-traumatic, chronic spinal cord dysfunction worldwide, causing debilitating disability with a diminishing quality of life. The natural history of DCM is poorly understood. This is a preliminary report of the first 60 patients recruited to the MYelopathy NAtural History (MYNAH) Registry.

METHODS

MYNAH Registry is an investigator-initiated, multicenter, prospective, non-interventional, longitudinal, national observational study (Registry ID ACSQHC-ARCR-258). Given the observational nature of the Registry, participants' clinical management plan is neither changed nor affected. Participants are recruited via an opt-in approach. A patient with DCM diagnosed by a spine/neurosurgeon after 1st January 2018 onwards is eligible to participate regardless of their surgical status. The Patient-Reported Outcome Measures (PROMs) are NDI, EQ5D5L and EQ-VAS; and the Practitioner-Reported Outcome Measures (PrROMs) are mJOA Score and Nurick Grade.

RESULTS

Sixty participants (n = 60) have now been recruited of which male participants 34 (56.7%) and females are 26 (43.3%), with a mean age of 62.3 years (SD 14.1) and biospecimens for Proteomics have been collected from 33 (66%) participants. The median mJOA Score was 16.5 (8-18), with myelopathy severity recorded as mild in 42 (70%), moderate in 13 (21.7%) and severe in 5 (8.3%) participants. Median Nurick Grade 0 (0-5), NDI 14 (0-45), EQ5D5L Score 0.850 (-0.288-1) and EQ-VAS 70 (10-96).

CONCLUSIONS

The MYNAH National DCM Registry in Australia is a novel spinal surgical initiative, that will inform the decision(s) to proceed with the scientific, evidence-based and personalised management of DCM globally in the future.

摘要

背景

退行性颈椎脊髓病(DCM)是全球非创伤性慢性脊髓功能障碍的最常见原因,导致使人衰弱的残疾,生活质量不断下降。人们对DCM的自然病史了解甚少。这是一份关于入选脊髓病自然病史(MYNAH)登记处的首批60例患者的初步报告。

方法

MYNAH登记处是一项由研究者发起的、多中心、前瞻性、非干预性、纵向的全国性观察性研究(登记号ACSQHC-ARCR-258)。鉴于该登记处的观察性质,参与者的临床管理计划既不会改变也不会受到影响。参与者通过选择加入的方式招募。2018年1月1日之后由脊柱/神经外科医生诊断为DCM的患者,无论其手术状态如何,均有资格参与。患者报告的结局指标(PROMs)为颈部功能障碍指数(NDI)、EQ5D5L和EQ视觉模拟量表(EQ-VAS);医生报告的结局指标(PrROMs)为改良日本骨科学会(mJOA)评分和努里克分级。

结果

现已招募60名参与者(n = 60),其中男性参与者34名(56.7%),女性26名(43.3%),平均年龄62.3岁(标准差14.1),已从33名(66%)参与者中收集了用于蛋白质组学研究的生物样本。mJOA评分中位数为16.5(8 - 18),42名(70%)参与者的脊髓病严重程度记录为轻度,13名(21.7%)为中度,5名(8.3%)为重度。努里克分级中位数为0(0 - 5),NDI为14(0 - 45),EQ5D5L评分为0.850(-0.288 - 1),EQ-VAS为70(10 - 96)。

结论

澳大利亚的MYNAH全国DCM登记处是一项新颖的脊柱外科倡议,它将为未来全球范围内对DCM进行科学、循证和个性化管理的决策提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3f3/12105558/42334da47ce4/ANS-95-979-g001.jpg

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