Evidence map›Paper›PMID 36856831›Full record

Observational studyActa neurochirurgica2023

Life expectancy in patients with degenerative cervical myelopathy is currently reduced but can be restored with timely treatment.

Benjamin M Davies, Daniel Stubbs, Conor S Gillespie, Ben Grodzinski, Ashwin Venkatesh, Matthew Guilfoyle, Mark R N Kotter, Rodney Laing

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Acta neurochirurgica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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

6 citing papers in PubMed.

  1. Article
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  5. Review
  6. 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

8 authors.

Benjamin M DaviesDepartment of Clinical Neurosurgery, University of Cambridge, Cambridge, UK. Bd375@cam.ac.uk.ORCID http://orcid.org/0000-0003-0591-5069
Daniel StubbsUniversity Department of Anaesthesiae, University of Cambridge, Cambridge, UK.
Conor S GillespieDepartment of Clinical Neurosurgery, University of Cambridge, Cambridge, UK.
Ben GrodzinskiUniversity Department of Anaesthesiae, University of Cambridge, Cambridge, UK.
Ashwin VenkateshDepartment of Clinical Neurosurgery, University of Cambridge, Cambridge, UK.
Matthew GuilfoyleDepartment of Clinical Neurosurgery, University of Cambridge, Cambridge, UK.
Mark R N KotterDepartment of Clinical Neurosurgery, University of Cambridge, Cambridge, UK.
Rodney LaingDepartment of Clinical Neurosurgery, University of Cambridge, Cambridge, UK.

Funding

Department of HealthWellcome Trust 204017/Z/16/Z
6 · The paper itself

Abstract

purposeDegenerative cervical myelopathy is a progressive slow-motion spinal cord injury. Surgery is the mainstay of treatment. Baseline disability predicts surgical recovery; therefore, timely treatment is critical to restoring function. However, current challenges mean most patients present with advanced disease and are instead left with life changing disabilities. While short-term mortality is rarely reported, the long-term effects of this on life expectancy are unknown, including whether function could be modifiable with timely treatment. This article investigates the effect of DCM on life expectancy.

methodsThe survival of patients from an observational study of patients undergoing surgery from 1994 to 2007 was compared to their expected survival using a gender- and aged -matched cohort. Comparisons were made by one sample log-rank test and standardised mortality ratios. Factors associated with survival were explored using a Cox regression analysis, including disease severity.

resultsA total of 357 patients were included in the analysis. After a median follow-up of 15.3 years, 135 of 349 patients had died; 114.7 deaths would have been expected. The DCM cohort had an increased risk of death compared to the non-DCM cohort (standardised mortality ratio 1.18 [95% CI: 1.02-1.34]. Age at operation 1.08 (95% CI: 1.07 to 1.1, p < 0.001) and severe DCM 1.6 (95% CI: 1.06 to 2.3, p = 0.02) were associated with worse survival (N = 287). In those surviving at least 2 years after surgery, only severe DCM was associated with conditional survival (HR 1.6, 95% CI 1.04 2.4, p = 0.03).

conclusionLife expectancy is reduced in those undergoing surgery for DCM. This is driven by premature mortality among those left with severe disability. As disability can be reduced with timely treatment, these findings reinforce the need for collective and global action to raise awareness of DCM and enable early diagnosis.

Indexed as

Spinal Cord DiseasesSpinal Cord InjuriesAgedCervical VertebraeHumansLife ExpectancyNeckCervical myelopathyCervical SpondylosisCervical StenosisDegenerationDegenerative Cervical MyelopathyOssification of the posterior longitudinal ligamentSurvival

Identifiers

PMID36856831
PMCPMC10140127

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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.