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Ventral Versus Dorsal Decompression for Cervical Spondylotic Myelopathy: Surgeonsʼ Assessment of Eligibility for Randomization in a Proposed Randomized Controlled Trial
- Source :
- Spine. 32:429-436
- Publication Year :
- 2007
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2007.
-
Abstract
- STUDY DESIGN Surgeons attending a Cervical Spine Research Society (CSRS) meeting were surveyed about the surgical approach to cervical spondylotic myelopathy (CSM). OBJECTIVE To elicit spine surgeons' opinions on the suitability of a panel of test cases for randomization in a proposed randomized controlled trial (RCT) of ventral versus dorsal decompression for CSM. SUMMARY OF BACKGROUND DATA The optimal surgical decompression strategy for CSM has not been defined. Specific eligibility criteria should be defined before a RCT is initiated. METHODS Twenty actual cases with images were prepared. Surgeons supplied demographic information, preferred surgical approach, and eligibility for randomization for 10 cases. RESULTS A total of 91 of 239 (38%) surgeons completed the survey. Of 900 case-strategy responses, 51% recommended ventral surgery, 38% dorsal surgery, and 11% a combined approach. Both overall C2-C7 kyphosis >5 degrees and a segmental kyphotic deformity were inversely correlated with eligibility for randomization (P < 0.001 for both). Using these 2 criteria plus age over 85 years, ossification of the posterior longitudinal ligament, and congenital canal stenosis as additional exclusion criteria, 12 of 20 survey cases were considered potentially eligible for randomization. Orthopedic and neurologic surgeons were similar in determining a case's eligibility for randomization. CONCLUSIONS These results measure surgeons' opinions on the suitability of cases for randomization and help to define entry and exclusion criteria for a RCT comparing ventral to dorsal strategies. Over 50% of CSM cases from a general spinal practice might be eligible for randomization.
- Subjects :
- Adult
Male
medicine.medical_specialty
Randomization
Adolescent
Decompression
Kyphosis
Eligibility Determination
law.invention
Randomized controlled trial
law
Physicians
Prone Position
Supine Position
Humans
Medicine
Orthopedics and Sports Medicine
Aged
Randomized Controlled Trials as Topic
Aged, 80 and over
business.industry
Data Collection
Patient Selection
Clinical study design
Middle Aged
Decompression, Surgical
medicine.disease
Surgery
Clinical trial
Stenosis
Orthopedic surgery
Cervical Vertebrae
Physical therapy
Regression Analysis
Female
Neurology (clinical)
business
Spinal Cord Compression
Subjects
Details
- ISSN :
- 03622436
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- Spine
- Accession number :
- edsair.doi.dedup.....2e5b6fff30a9378a9a894b7ec58436b6