Is Decompressive Surgery for Cervical Spondylotic Myelopathy Effective in Patients Suffering from Concomitant Multiple Sclerosis or Parkinson’s Disease?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy
2.2. Eligibility Criteria
3. Results
3.1. Concurrent Multiple Sclerosis and Cervical Spondylotic Myelopathy
3.1.1. Surgical Outcomes in Patients with Concurrent MS and CSM
3.1.2. Quality-of-Life Outcomes in Patients with Concurrent MS and CSM
3.2. Concurrent Parkinson’s Disease and Cervical Spondylotic Myelopathy
4. Limitations
5. Conclusions
Author Contributions
Conflicts of Interest
References
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Authors | Year | Number of Patients | Surgical Intervention | Mean Follow-Up Time (Months) | Main Study Findings |
---|---|---|---|---|---|
Concurrent Multiple Sclerosis and Cervical Spondylotic Myelopathy | |||||
Surgical Outcomes in Patients with Concurrent MS and CSM | |||||
Brain and Wilkinson [9] | 1957 | 17 with MS and CSM | Laminectomy | -------- | Patients reported poor outcomes following laminectomy, particularly for those with disseminated sclerosis. |
Young et al. [10] | 1999 | 7 with MS and CSM | Decompression | 14 (range 6–24) | 5 patients showed postoperative improvement in spondylosis symptoms. 1 patient developed acute MS symptoms a day after surgery. |
Arnold et al. [11] | 2011 | 15 with MS and cervical myeloradiculopathy | Decompression, fusion, and fixation | 47 | 13 patients demonstrated objective improvement in upper and lower extremity strength and neck and/or upper extremity pain or paresthesias. |
Burgerman et al. [12] | 1992 | 6 with MS and CSM | Anterior cervical discectomy or cervical laminectomy | 30 (12–72) | Long-term improvement in 2/3 patients with anterior cervical discectomy. 1 patient treated with cervical laminectomy showed only transient clinical improvement. 3 patients (2 laminectomies, 1 anterior cervical discectomy) showed no change in symptoms. |
Lubelski et al. [13] | 2014 | 77 with MS and CSM; 77 with CSM | Cervical decompression | 57.7 ± 43.3 (MS and CSM); 49.4 ± 42.5 (CSM) | 39% in the MS group did not have myelopathy improvement in the short-term vs. 23% in the control group (p = 0.04) and, in the long-term, 44% in the MS group did not improve vs. 19% in the control group (p = 0.004). |
Bashir et al. [14] | 2000 | 14 with MS and spinal cord compression | Cervical decompression | 45.6 (range, 12.0–117.6) | All patients with neck pain reported improvement in or elimination of their pain (n = 11). 6/10 patients with cervical radiculopathy reported complete resolution of their radicular symptoms, and 4 reported a reduction. 7/13 patients with progressive myelopathy experienced no improvement in symptoms. |
Tan et al. [15] | 2014 | 18 with MS and CSM | Cervical decompression and fusion | 18 (range, 3–45) | 4 reported improvement (28.6%), 9 (64.3%) reported stabilization, and 1 (7.1%) described a worsening of myelopathy. All 7 patients with neck pain described elimination of or significant improvement in symptoms. |
Quality-of-Life Outcomes in Patients with Concurrent MS and CSM | |||||
Lubelski et al. [16] | 2014 | 13 with MS and CSM; 52 controls with CSM | Cervical decompression | 22.3 ± 10.6 (MS and CSM); 18.2 ± 10.8 (CSM) | QALY in the MS and CSM group did not change significantly from pre- to post-operation (p = 0.96) vs. a significant change in the control CSM group from a QALY of 0.50 to 0.64 (p < 0.0001). |
Concurrent Parkinson’s Disease and Cervical Spondylotic Myelopathy | |||||
Xiao et al. [17] | 2016 | 11 with PD and CSM; 44 controls with CSM | Cervical decompression | 12.4 ± 16.2 (PD and CSM); 13.4 ± 11.3 (CSM) | Patients with PD and CSM reported worse quality-of-life at last follow-up than controls (0.526 vs. 0.707, p = 0.01). PD and CSM patients did have improvement in pain-related disability. |
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Purvis, T.E.; Lubelski, D.; Mroz, T.E. Is Decompressive Surgery for Cervical Spondylotic Myelopathy Effective in Patients Suffering from Concomitant Multiple Sclerosis or Parkinson’s Disease? Brain Sci. 2017, 7, 39. https://doi.org/10.3390/brainsci7040039
Purvis TE, Lubelski D, Mroz TE. Is Decompressive Surgery for Cervical Spondylotic Myelopathy Effective in Patients Suffering from Concomitant Multiple Sclerosis or Parkinson’s Disease? Brain Sciences. 2017; 7(4):39. https://doi.org/10.3390/brainsci7040039
Chicago/Turabian StylePurvis, Taylor E., Daniel Lubelski, and Thomas E. Mroz. 2017. "Is Decompressive Surgery for Cervical Spondylotic Myelopathy Effective in Patients Suffering from Concomitant Multiple Sclerosis or Parkinson’s Disease?" Brain Sciences 7, no. 4: 39. https://doi.org/10.3390/brainsci7040039