caa a22 4500 445831685 CHVBK 20180317145317.0 cr unu---uuuuu 170323e20110901xx s 000 0 eng 10.1007/s00586-011-1811-9 doi (NATIONALLICENCE)springer-10.1007/s00586-011-1811-9 Cervical spondylotic myelopathy: conservative versus surgical treatment after 10years [Elektronische Daten] [Zdeněk Kadaňka, Josef Bednařík, Oldřich Novotný, Igor Urbánek, Ladislav Dušek] It is not known whether the results of decompressive surgery to treat the mild and moderate forms of spondylotic cervical myelopathy (CSM) are any better than those of a conservative approach. A 10-year prospective randomised study was performed. The objective of the study was to compare conservative and operative treatments of mild and moderate, non-progressive, or slowly progressive, forms of CSM. Sixty-four patients were randomised into two groups of 32. Group A was treated conservatively while group B was treated surgically. The clinical outcome was evaluated by modified JOA score, timed 10-m walk, score of daily activities recorded by video and evaluated by two observers blinded to the type of therapy, and by subjective assessment by the patients themselves. Seventeen patents died of natural, unrelated causes, during the follow-up. A total of 25 patients in the conservatively and 22 in the surgically treated group were used for the final evaluation. There was no statistically significant difference between both groups in mJOA score, in subjective evaluation by the patients themselves and in evaluation of video-recordings of daily living activities by two observers blinded to treatment mode. There was neither any difference found in the percentage of patients losing the ability to walk nor in the time taken to cover the 10-m track from a standing start. Comparison of conservative and surgical treatment in mild and moderate forms of CSM in a 10-year follow-up has not shown, on average, a significant difference in results. In both groups, patients get better and worse. According to the power analysis it is necessary admit that these results possess the low ability to answer definitely the question which treatment is better for the patients with a mild and moderate non-progressive CSM because of the low number of patients for the final evaluation and for clinically negligible differences between two compared arms. These findings can serve as a worthy odds-on hypothesis which needs the confirmation. Springer-Verlag, 2011 Spondylotic cervical myelopathy nationallicence Conservative treatment nationallicence Cervical spondylosis nationallicence Kadaňka Zdeněk Department of Neurology, Masaryk University and University Hospital Brno, Jihlavská 20, 63900, Brno, Czech Republic aut Bednařík Josef Department of Neurology, Masaryk University and University Hospital Brno, Jihlavská 20, 63900, Brno, Czech Republic aut Novotný Oldřich Department of Neurology, Masaryk University and University Hospital Brno, Jihlavská 20, 63900, Brno, Czech Republic aut Urbánek Igor Department of Neurology, Masaryk University and University Hospital Brno, Jihlavská 20, 63900, Brno, Czech Republic aut Dušek Ladislav Centre of Biostatistics and Analyses, Masaryk University Brno, Brno, Czech Republic aut European Spine Journal Springer-Verlag 20/9(2011-09-01), 1533-1538 0940-6719 20:9<1533 2011 20 586 https://doi.org/10.1007/s00586-011-1811-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-011-1811-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kadaňka Zdeněk Department of Neurology, Masaryk University and University Hospital Brno, Jihlavská 20, 63900, Brno, Czech Republic aut NATIONALLICENCE 700 1- Bednařík Josef Department of Neurology, Masaryk University and University Hospital Brno, Jihlavská 20, 63900, Brno, Czech Republic aut NATIONALLICENCE 700 1- Novotný Oldřich Department of Neurology, Masaryk University and University Hospital Brno, Jihlavská 20, 63900, Brno, Czech Republic aut NATIONALLICENCE 700 1- Urbánek Igor Department of Neurology, Masaryk University and University Hospital Brno, Jihlavská 20, 63900, Brno, Czech Republic aut NATIONALLICENCE 700 1- Dušek Ladislav Centre of Biostatistics and Analyses, Masaryk University Brno, Brno, Czech Republic aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/9(2011-09-01), 1533-1538 0940-6719 20:9<1533 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer