Evidence map›Paper›PMID 38912784›Full record

Trial reportNeurosurgery2025

Patients May Return to Work Sooner After Laminoplasty: Occupational Outcomes of the Cervical Spondylotic Myelopathy Surgical Trial.

Stephen P Miranda, Robert G Whitmore, Adam Kanter, Praveen V Mummaneni, Erica F Bisson, Fred G Barker, James Harrop, Subu N Magge, Robert F Heary, Michael G Fehlings and 8 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Review
  2. Article
  3. 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

18 authors.

Stephen P MirandaDepartment of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia , Pennsylvania , USA.ORCID 0000-0002-6126-3141
Robert G WhitmoreDepartment of Neurosurgery, Lahey Hospital and Medical Center, Burlington , Massachusetts , USA.
Adam KanterDepartment of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh , Pennsylvania , USA.
Praveen V MummaneniDepartment of Neurological Surgery, University of California San Francisco, San Francisco , California , USA.
Erica F BissonDepartment of Neurosurgery Clinical Neurosciences Center, University of Utah School of Medicine, Salt Lake City , Utah , USA.
Fred G BarkerBrain Tumor Center, Massachusetts General Hospital, Boston , Massachusetts , USA.
James HarropDepartment of Neurological Surgery, Thomas Jefferson University, Philadelphia , Pennsylvania , USA.
Subu N MaggeDepartment of Neurosurgery, Lahey Hospital and Medical Center, Burlington , Massachusetts , USA.
Robert F HearyDepartment of Neurological Surgery, Hackensack Meridian School of Medicine, Nutley , New Jersey , USA.
Michael G FehlingsDivision of Neurosurgery and Spine Program, Department of Surgery, University of Toronto, Toronto , Ontario , Canada.
Todd J AlbertDepartment of Orthopaedic Surgery, Hospital for Special Surgery, New York , New York , USA.
Paul M ArnoldCarle Neuroscience Institute, Carle Foundation Hospital, Urbana , Illinois , USA.
K Daniel RiewDepartment of Neurosurgery, Weill Cornell Medicine, New York , New York , USA.
Michael P SteinmetzCenter for Spine Health, Cleveland Clinic Foundation, Cleveland , Ohio , USA.
Marjorie C WangDepartment of Neurosurgery, Medical College of Wisconsin, Milwaukee , Wisconsin , USA.
John G HellerThe Emory Orthopaedics & Spine Center, Emory University School of Medicine, Atlanta , Georgia , USA.
Edward C BenzelCenter for Spine Health, Cleveland Clinic Foundation, Cleveland , Ohio , USA.
Zoher GhogawalaDepartment of Neurosurgery, Lahey Hospital and Medical Center, Burlington , Massachusetts , USA.

Funding

Cervical Spondylotic Myelopathy (CSM) Investigators ConferenceR13AR065834 · NIAMS · LAHEY CLINIC · PI GHOGAWALA, ZOHER · 2013 to 2013
$15k
NIAMS NIH HHS R13 AR065834NIH HHS 1R13AR065834-01Patient-Centered Outcomes Research Institute CE-1304-6173
6 · The paper itself

Abstract

BACKGROUND AND

objectivesReturn-to-work (RTW) is an important outcome for employed patients considering surgery for cervical spondylotic myelopathy (CSM). We conducted a post hoc analysis of patients as-treated in the Cervical Spondylotic Myelopathy Surgical Trial, a prospective, randomized trial comparing surgical approaches for CSM to evaluate factors associated with RTW.

methodsIn the trial, patients were randomized (2:3) to either anterior surgery (anterior cervical decompression/fusion [ACDF]) or posterior surgery (laminoplasty [LP], or posterior cervical decompression/fusion [PCDF], at surgeon's discretion). Work status was recorded at 1, 3, 6, and 12 months postoperatively. For patients working full-time or part-time on enrollment, time to RTW was compared across as-treated surgical groups using discrete-time survival analysis. Multivariate logistic regression was used to assess predictors of RTW. Clinical outcomes were compared using a linear mixed-effects model.

resultsA total of 68 (42%) of 163 patients were working preoperatively and were analyzed. In total, 27 patients underwent ACDF, 29 underwent PCDF, and 12 underwent LP. 45 (66%) of 68 patients returned to work by 12 months. Median time to RTW differed by surgical approach (LP = 1 month, ACDF = 3 months, PCDF = 6 months; P = .02). Patients with longer length-of-stay were less likely to be working at 1 month (odds ratio 0.51; 95% CI, 0.29-0.91; P = .022) and 3 months (odds ratio 0.39; 95% CI, 0.16-0.96; P = .04). At 3 months, PCDF was associated with lower Short-Form 36 physical component summary scores than ACDF (estimated mean difference [EMD]: 6.42; 95% CI, 1.4-11.4; P = .007) and LP (EMD: 7.98; 95% CI, 2.7-13.3; P = .003), and higher Neck Disability Index scores than ACDF (EMD: 12.48; 95% CI, 2.3-22.7; P = .01) and LP (EMD: 15.22; 95% CI, 2.3-28.1; P = .014), indicating worse perceived physical functioning and greater disability, respectively.

conclusionMost employed patients returned to work within 1 year. LP patients resumed employment earliest, while PCDF patients returned to work latest, with greater disability at follow-up, suggesting that choice of surgical intervention may influence occupational outcomes.

Indexed as

Cervical VertebraeDecompression, SurgicalLaminoplastyReturn to WorkSpondylosisAdultAgedFemaleHumansMaleMiddle AgedProspective StudiesSpinal Cord DiseasesSpinal FusionTreatment Outcome

Identifiers

PMID38912784
PMCPMC12245235

What OpenQuestion holds

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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.