Evidence map›Paper›PMID 33740929›Full record

ArticleBMC surgery2021

Predictors associated with neurological recovery after anterior decompression with fusion for degenerative cervical myelopathy.

Hiroyuki Inose, Takashi Hirai, Toshitaka Yoshii, Atsushi Kimura, Katsushi Takeshita, Hirokazu Inoue, Asato Maekawa, Kenji Endo, Takeo Furuya, Akira Nakamura and 7 more

Open access · goldAbstract readMulticenter Study
In one paragraph

Article in BMC surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
  2. [Research progress on three-dimensional printed interbody fusion cage].Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengxue zazhi · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 8 institutions in 1 country.

Hiroyuki InoseDepartment of Orthopaedic and Trauma Research, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan. inose.orth@tmd.ac.jp.ORCID http://orcid.org/0000-0003-4195-2545
Takashi HiraiDepartment of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Toshitaka YoshiiDepartment of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Atsushi KimuraDepartment of Orthopaedics, Jichi Medical University, Shimotsuke, Japan.
Katsushi TakeshitaDepartment of Orthopaedics, Jichi Medical University, Shimotsuke, Japan.
Hirokazu InoueDepartment of Orthopaedics, Jichi Medical University, Shimotsuke, Japan.
Asato MaekawaDepartment of Orthopaedic Surgery, Tokyo Medical University, Tokyo, Japan.
Kenji EndoDepartment of Orthopaedic Surgery, Tokyo Medical University, Tokyo, Japan.
Takeo FuruyaDepartment of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Akira NakamuraDepartment of Orthopaedic Surgery, Shiga University of Medical Science, Otsu, Japan.
Kanji MoriDepartment of Orthopaedic Surgery, Shiga University of Medical Science, Otsu, Japan.
Shunsuke KanbaraDepartment of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Shiro ImagamaDepartment of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Shoji SekiDepartment of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan.
Shunji MatsunagaDepartment of Orthopedic Surgery, Imakiire General Hospital, Kagoshima, Japan.
Kunihiko TakahashiDepartment of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan.
Atsushi OkawaDepartment of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Tokyo Medical and Dental University · JPJichi Medical University · JPNagoya University · JPShiga University of Medical Science · JPTokyo Medical University · JPChiba University · JPImakiire General Hospital · JPUniversity of Toyama · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAnterior decompression with fusion (ADF) has often been performed for degenerative cervical myelopathy (DCM) in patients with poor cervical spine alignment and/or anterior cord compression. We aimed to identify clinical and radiological predictors associated with neurological recovery after ADF.

methodsThis post-hoc analysis from a prospective multicenter study included patients who were scheduled for ADF for DCM. The patients who received other surgeries (laminoplasty, posterior decompression and fusion) were excluded. The associations between baseline clinical and radiographic variables (age, sex, body mass index, etiology, cervical lordosis, range of motion, C7 slope, C2-7 sagittal vertical axis [SVA], thoracic kyphosis [TK], lumbar lordosis, sacral slope, SVA, pelvic tilt, T1 pelvic angle [TPA], the Japanese Orthopedic Association score for the assessment of cervical myelopathy [C-JOA], European Quality of Life Five Dimensions Scale [EQ-5D], Neck Disability Index [NDI], Physical Component Summary of the SF-36 [PCS], and Mental Component Summary of the SF-36) and the recovery rates as the outcome variables were investigated in the univariate regression analysis. Then, the independent predictors for increased recovery rates were evaluated using a stepwise multiple regression analysis.

resultsIn total, 37 patients completed the 1 year follow-up. The recovery rate was significantly correlated with SVA (p = 0.001) and TPA (p = 0.03). Univariate regression analyses showed that age (Regression coefficient = - 0.92, p = 0.049), SVA (Regression coefficient  = - 0.57, p = 0.004) and PCS (Regression coefficient = 0.80, p = 0.03) score were significantly associated with recovery rate. Then, a stepwise multiple regression analysis identified the independent predictors of recovery rate after ADF as TK (p = 0.01), PCS (p = 0.03), and SVA (p = 0.03). According to this prediction model, the following equation was obtained: recovery rate = - 8.26 + 1.17 × (TK) - 0.45 × (SVA) + 0.85 × (PCS) (p = 0.002, R

conclusionPatients with lower TK, lower PCS score, and higher SVA were more likely to have poor neurological recovery after ADF. Therefore, patients with DCM and these predictors who undergo ADF should be warned about poor recovery and be required to provide adequate informed consent.

Indexed as

DecompressionSpinal Cord DiseasesAgedCervical VertebraeFemaleHumansMaleMiddle AgedProspective StudiesTreatment OutcomeNeck PainOssification of Posterior Longitudinal LigamentSpinal FusionSpinal StenosisSpondylosis

Identifiers

PMID33740929
PMCPMC7980318
OpenAlexW3133605967

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.