Does Posterior Cervical Decompression Conducted by Junior Surgeons Affect Clinical Outcomes in the Treatment of Cervical Spondylotic Myelopathy? Results From a Multicenter Study.

board-certified spine surgeon cervical spondylotic myelopathy multicenter study posterior cervical decompression surgical outcomes

Journal

Global spine journal
ISSN: 2192-5682
Titre abrégé: Global Spine J
Pays: England
ID NLM: 101596156

Informations de publication

Date de publication:
Feb 2019
Historique:
entrez: 19 2 2019
pubmed: 19 2 2019
medline: 19 2 2019
Statut: ppublish

Résumé

Retrospective multicenter study. To evaluate the outcomes of posterior cervical decompression for cervical spondylotic myelopathy (CSM) when performed by board-certified spine (BCS) or non-BCS (NBCS) surgeons. We reviewed outcomes for 675 patients who underwent surgery for CSM, were followed at least 1 year after surgery, and were assessed preoperatively and at final follow-up by Japanese Orthopaedic Association (JOA) scores and by the visual analog scale (VAS) for the neck. Cervical alignment was assessed on radiographs by C2-C7 angles, and range of motion (ROM) by extension minus flexion C2-C7 angles. We compared outcomes for BCS surgeons, who must meet several requirements, including experience in more than 300 spinal surgeries, and for NBCS surgeons. BCS surgeons performed 432 of 675 laminoplasties. NBCS surgeons were primary in 243 surgeries, of which 187 were directly supervised by a BCS surgeon. BCS surgeons required significantly less time in surgery (98.0 ± 39.5 vs 108.1 ± 49.7 min; Surgical outcomes such as functional recovery, complication rates, and cervical dynamics were comparable between the BCS and NBCS groups. Thus, posterior cervical decompression for CSM is safe and effective when performed by junior surgeons who have been trained and supervised by experienced spine surgeons.

Identifiants

pubmed: 30775205
doi: 10.1177/2192568218756329
pii: 10.1177_2192568218756329
pmc: PMC6362553
doi:

Types de publication

Journal Article

Langues

eng

Pagination

25-31

Déclaration de conflit d'intérêts

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Auteurs

Narihito Nagoshi (N)

Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Keio Spine Research Group (KSRG), Tokyo, Japan.

Akio Iwanami (A)

Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Keio Spine Research Group (KSRG), Tokyo, Japan.
Koga Hospital Spine Center, Koga, Japan.

Norihiro Isogai (N)

Keio Spine Research Group (KSRG), Tokyo, Japan.
Spine and Spinal Cord Center, International University of Health and Welfare (IUHW) Mita Hospital, Minato-ku, Tokyo, Japan.

Masayuki Ishikawa (M)

Keio Spine Research Group (KSRG), Tokyo, Japan.
Spine and Spinal Cord Center, International University of Health and Welfare (IUHW) Mita Hospital, Minato-ku, Tokyo, Japan.
Department of Orthopedic Surgery, School of Medicine, International University of Health and Welfare (IUHW), Narita, Chiba, Japan.

Kenya Nojiri (K)

Keio Spine Research Group (KSRG), Tokyo, Japan.
Department of Orthopedic Surgery, Isehara Kyodo Hospital, Isehara, Kanagawa, Japan.

Takashi Tsuji (T)

Keio Spine Research Group (KSRG), Tokyo, Japan.
Department of Orthopedic Surgery, Fujita Health University, Toyoake, Mie, Japan.

Kenshi Daimon (K)

Keio Spine Research Group (KSRG), Tokyo, Japan.
Department of Orthopedic Surgery, Ogikubo Hospital, Suginami, Tokyo, Japan.

Ayano Takeuchi (A)

Department of Preventive Medicine and Public Health, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.

Osahiko Tsuji (O)

Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Keio Spine Research Group (KSRG), Tokyo, Japan.

Eijiro Okada (E)

Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Keio Spine Research Group (KSRG), Tokyo, Japan.

Nobuyuki Fujita (N)

Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Keio Spine Research Group (KSRG), Tokyo, Japan.

Mitsuru Yagi (M)

Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Keio Spine Research Group (KSRG), Tokyo, Japan.

Kota Watanabe (K)

Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Keio Spine Research Group (KSRG), Tokyo, Japan.

Masaya Nakamura (M)

Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Keio Spine Research Group (KSRG), Tokyo, Japan.

Morio Matsumoto (M)

Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Keio Spine Research Group (KSRG), Tokyo, Japan.

Ken Ishii (K)

Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Keio Spine Research Group (KSRG), Tokyo, Japan.
Spine and Spinal Cord Center, International University of Health and Welfare (IUHW) Mita Hospital, Minato-ku, Tokyo, Japan.
Department of Orthopedic Surgery, School of Medicine, International University of Health and Welfare (IUHW), Narita, Chiba, Japan.

Junichi Yamane (J)

Keio Spine Research Group (KSRG), Tokyo, Japan.
National Hospital Organization Murayama Medical Center, Musashimurayama City, Tokyo, Japan.

Classifications MeSH