Cervical Spondylosis With Myelopathy Clinical Trial
Official title:
Predictors of Outcome and Natural History in Patients With Cervical Spondylotic Myelopathy
Cervical spondylotic myelopathy (CSM) is the most frequent cause of myelopathy in those over the age of 50. They claim that surgical treatment of myelopathy, especially of the mild and moderate forms, has not shown better results than conservative treatment in the long term, and criteria for the indication and the timing of the operation have not been established. In order to get some more reliable data, a long-term follow up observational study will be started to confirm the effects of long term for conservative treatment.
Cervical spondylotic myelopathy (CSM) is the most frequent cause of myelopathy in those over
the age of 50 [1]. It is believed to have a generally progressive course over a period of
years, with sudden acceleration especially following a slight head and neck injury, leading
to significant disability [2, 3]. The treatment of CSM remains a problem, particularly in
the mild and moderate forms without rapid progression.
Excellent outcomes for surgery have been presented in many studies. All of the studies,
however, are retrospective, and many lack a clear design, standard criteria, control groups,
and sufficient follow-up, so it is difficult to compare [4, 5, 6]. Furthermore, several
studies and critical reviews are not so optimistic. They claim that surgical treatment of
myelopathy, especially of the mild and moderate forms, has not shown better results than
conservative treatment in the long term, and criteria for the indication and the timing of
the operation have not been established [7, 8, 9]. Twenty-five percent of patients with
laminoplasty suffer from severe neck and shoulder pain for more than 3 months [10], with
significant morbidity from the iliac crest donor site etc. Surgery to decompress and
stabilize the spine is often advocated for severe or progressive symptoms, with mixed
results. About two-thirds of patients improve with surgery, whereas surgery is not
successful in 15% to 30% of cases [11].
In order to get some more reliable data, a long-term follow up observational study will be
started to confirm the effects of long term for conservative treatment.
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Observational Model: Cohort, Time Perspective: Prospective
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