Patient-Reported Outcome Trajectories the first 24 months after surgery for Cervical Spondylotic Myelopathy: A Quality Outcomes Database Study

Saturday, May 4, 2024

3:51 PM – 3:53 PM CT

Location: S403ab

Presenting Author(s)

Daniel Zeitouni, MD (he/him/his)

Neurosurgery Resident
Carolina Neurosurgery & Spine Associates
Charlotte, NC, US

Co-Author(s)

Anthony L. Asher, MD

President AANS, Clinical Professor
Neuroscience Institute, Carolina Neurosurgery & Spine Associates
Charlotte, North Carolina, United States
Erica F. Bisson, MD, MPH

Professor
University of Utah
Salt Lake City, UT, US
Mohamad Bydon, MD, FAANS

Professor of Neurosurgery
Mayo Clinic
Rochester, MN, US
Andrew K. Chan, MD

Assistant Professor of Neurological Surgery
Columbia University Irving Medical Center
New York, NY, US
Dean Chou, MD

Chief of the Spine Division, Professor, and Vice Chair of Neurosurgery
Columbia University
New York, New York, United States
Domagoj Coric, MD

Neurosurgeon
Carolina Neurosurgery & Spine Associates
Charlotte, NC, US
Kevin T. Foley, MD

Professor
Semmes-Murphey Neurologic and Spine Institute, University of Tennessee
Memphis, TN, US
KF

Kai-Ming Fu, MD, PhD

Associate Professor
Weill Cornell Medical Center
New York, NY, US
OG

Oren N. Gottfried, MD

Professor of Neurosurgery
Duke University
Durham, North Carolina, United States
Regis William Haid, Jr., MD

Neurosurgeon
Atlanta Brain and Spine
Atlanta, GA, US
Sufyan Ibrahim, MBBS

Research Fellow
Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55902, USA
Rochester, Minnesota, United States
Sarah E. Johnson, MBBS

Postdoctoral Research Fellow
Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55902, USA
John Knightly, MD, FAANS (he/him/his)

Vice President
AANS
Cedar Knolls, NJ, US
Praveen V. Mummaneni, MD, MBA

Joan O'Reilly Endowed Professor and Vice Chair of Neurosurgery
Department of Neurological Surgery, University of California, San Francisco
San Francisco, CA, US
PP

Paul Park, MD

Professor of Neurosurgery
Semmes-Murphey Neurologic and Spine Institute
MEMPHIS, TN, US
Eric Potts, MD

Neurosurgeon
Goodman Campbell Brain and Spine
Carmel, IN, US
Christopher I. Shaffrey, MD

Professor of Spine Surgery
Duke University Medical Center
Durham, NC, US
MS

Mark Shaffrey, MD

Chair - Department of Neurosurgery
University of Virginia
Charlottesville, VA, US
Luis M. Tumialan, MD

Professor of Neurosurgery
Barrow Brain and Spine
Paradise Valley, AZ, US
Jay D. Turner, MD, PhD

Neurosurgery Faculty
Barrow Neurological Institute
Phoenix, AZ, US
Cheerag Upadhyaya, MD, MBA (he/him/his)

Vice Chair of Outpatient Operations, Chief of Business Development and Strategy, Associate Professor of Neurosurgery
University of North Carolina
Chapel Hill, North Carolina, United States
JU

Juan Uribe, MD

Vice Char of Neurosurgery
Barrow Neurological Institute
bogota, Colombia
MV

Michael S. Virk, MD, PhD

Assistant Professor
Weill Cornell Medical Center
New York, New York, United States
Michael Y. Wang, MD

Professor
University of Miami
Miami, FL, US

Disclosure(s):

Daniel Zeitouni, MD: No financial relationships to disclose

Anthony L. Asher, MD: Globus: Royalty Recipient (Ongoing)

Erica F. Bisson, MD, MPH: No financial relationships to disclose

Mohamad Bydon, MD, FAANS: No financial relationships to disclose

Andrew K. Chan, MD: No financial relationships to disclose

Dean Chou, MD: Cerapedics: Grant/Research Support (Ongoing); Cervical Scoliosis Research Society: Grant/Research Support (Ongoing); Globus Medical: Research Grant (Ongoing); Medtronic: Research Grant (Ongoing); Nuvasive: Research Grant (Ongoing); Royal Biologics: Consultant (Ongoing); Spine Committee: Board Member/Officer/Trustee (Ongoing); Spinevision: Consultant (Ongoing); SpineWave: Consultant (Ongoing); Terumo: Consultant (Ongoing)

Domagoj Coric, MD: 3Spine: Stock Shareholder (excluding mutual funds) (Ongoing); Globus Medical: Royalty Recipient (Ongoing); Medtronic: Consultant (Ongoing), Royalty Recipient (Ongoing); Premia Spine: Consultant (Ongoing), Stock Shareholder (excluding mutual funds) (Ongoing); Pressio: Stock Shareholder (excluding mutual funds) (Ongoing); Spine Wave: Consultant (Ongoing), Royalty Recipient (Ongoing), Stock Shareholder (excluding mutual funds) (Ongoing)

Kevin T. Foley, MD: Accelus: Stock Shareholder (excluding mutual funds) (Ongoing); Discgenics: Stock Shareholder (excluding mutual funds) (Ongoing); DuraStat: Stock Shareholder (excluding mutual funds) (Ongoing); Medtronic: Consultant (Ongoing), Royalty Recipient (Ongoing), Stock Shareholder (excluding mutual funds) (Ongoing); RevBio: Stock Shareholder (excluding mutual funds) (Ongoing); True Digital Surgery: Stock Shareholder (excluding mutual funds) (Ongoing); Vori Health: Stock Shareholder (excluding mutual funds) (Ongoing)

Kai-Ming Fu, MD, PhD: ATEC: Consultant (Terminated, December 1, 2023); Bioventus: Consultant (Ongoing); DePuy: Consultant (Ongoing)

Regis William Haid, MD, Jr.: Globus Medical: Royalty Recipient (Ongoing), Stock Shareholder (excluding mutual funds) (Ongoing); MDT: Royalty Recipient (Ongoing)

Sufyan Ibrahim, MBBS: No financial relationships to disclose

Sarah E. Johnson, MBBS: No financial relationships to disclose

John Knightly, MD, FAANS: No financial relationships to disclose

Praveen V. Mummaneni, MD, MBA: AO Spine: Grant/Research Support (Ongoing); BK Medical: Speaker/Honoraria (Ongoing); Brainlab: Speaker/Honoraria (Ongoing); Depuy Synthes: Consultant (Ongoing); DOD: Research Grant (Ongoing); Globus: Consultant (Ongoing); ISSG: Grant/Research Support (Ongoing); NIH: Research Grant (Ongoing); NREF: Grant/Research Support (Ongoing); Pacira: Grant/Research Support (Ongoing); PCORI: Grant/Research Support (Ongoing); SI Bone: Speaker/Honoraria (Ongoing); SLIP II: Grant/Research Support (Ongoing); Springer Publisher: Royalty Recipient (Ongoing); Thieme Publisher: Royalty Recipient (Ongoing)

Paul Park, MD: Accelus: Consultant (Ongoing); Cerapedics: Grant/Research Support (Terminated, July 15, 2022); Depuy Spine: Consultant (Terminated, July 15, 2022), Grant/Research Support (Terminated, July 15, 2022); Globus Medical: Consultant (Ongoing), Royalty Recipient (Ongoing); ISSG: Grant/Research Support (Ongoing); Medtronic: Consultant (Ongoing); Nuvasive: Consultant (Ongoing); SI Bone: Grant/Research Support (Terminated, July 15, 2022); SMISS: Grant/Research Support (Ongoing)

Eric Potts, MD: Medtronic: Consultant (Ongoing), Royalty Recipient (Ongoing)

Christopher I. Shaffrey, MD: No financial relationships to disclose

Mark Shaffrey, MD: No financial relationships to disclose

Luis M. Tumialan, MD: No financial relationships to disclose

Jay D. Turner, MD, PhD: Alphatec: Consultant (Ongoing), Grant/Research Support (Ongoing), Royalty Recipient (Ongoing); Seaspine: Consultant (Ongoing), Royalty Recipient (Ongoing); SI Bone: Consultant (Ongoing), Grant/Research Support (Ongoing), Royalty Recipient (Ongoing)

Cheerag Upadhyaya, MD, MBA: No financial relationships to disclose

Michael Y. Wang, MD: Depuy-Synthes: Consultant (Ongoing), Royalty Recipient (Ongoing); ISD: Stock Shareholder (excluding mutual funds) (Ongoing); Kinesiometrics: Stock Shareholder (excluding mutual funds) (Ongoing); Medical Device Partners: Stock Shareholder (excluding mutual funds) (Ongoing); NuVasive: Consultant (Ongoing); Pacira Pharmaceuticals: Consultant (Ongoing); Spineology: Consultant (Ongoing); Stryker: Consultant (Ongoing)

Introduction: Cervical spondylotic myelopathy (CSM) shows varying levels of improvement after surgical treatment. The goal of this study is to compare postoperative improvement and patient-reported outcomes up to two years after surgical treatment for CSM. This will help optimize current treatment strategies and effectively manage patient expectations.

Methods: This was a retrospective study of prospectively collected data using the Quality Outcomes Database (QOD). The primary outcomes of interest were the achievement of MCIDs for NDI, NRS neck pain, NRS arm pain, EQ5D and post-operative satisfaction (NASS). Early and sustained improvement was defined as MCID achievement in at least one outcome at all follow-up time points (3-, 12- and 24-month); transient improvement was defined as MCID achievement only at 3-month follow-up and/or 12-month follow-up, and late improvement was defined as MCID achievement in at least one clinical outcome only at 12-month and/or 24-month follow-up. Patients with data available at baseline and all follow-up time points were included in the subgroup and multivariable analyses based on patterns of improvement.

Results: Out of 1,141 patients that underwent surgery for CSM, 633 had PROs at 3, 12, and 24 months. 423 patients achieved early and sustained improvement (66.8%), 106 experienced transient improvement with subsequent decline (16.7%), 70 patients reported late improvement at 2 years (11.1%) and 34 patients did not report any improvement (5.4%). Overall satisfaction was 87.6% (550/633); patients who reported early and sustained improvement had significantly higher rates of satisfaction (94.3% vs. 67.0% vs. 88.1% vs. 67.6%, p< 0.01).

Conclusion : Our findings indicate that most patients undergoing surgery for CSM achieve long-term satisfaction (87.6%). Almost 67% of patients in this study had an early and sustained improvement of NDI, neck pain, arm pain, and/or quality of life, with an additional 11% reporting late improvement at 2 year follow up. This study will help guide surgical decisions and manage patient expectations before surgical treatment for CSM.