Elsevier Inc
Natural History of Degenerative Cervical Myelopathy
Jan 24, 2024
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5 min
This systematic review and meta-analysis evaluates surgical management strategies for olecranon fractures in adult patients, comparing tension-band wiring (TBW) with plate fixation (PF). The review included 24 studies, with 10 studies incorporated into the meta-analysis comparing TBW and PF.
Methodology
The analysis included six prospective cohorts or randomized controlled trials identified from an initial pool of 9570 studies. These studies were selected based on their relevance to the natural history of DCM.Significance and Relevance
Key Findings
Neurological Stability Estimates: The pooled survival estimates for neurological stability in mild DCM patients are as follows:
91% at 1 year
85% at 2 years
84% at 3 years
75% at 5 years
66% at 15 years
65% at 20 years
Moderate/Severe DCM Patients: For patients with moderate to severe DCM, the estimates are:
83% at 1 year
72% at 2 years
71% at 3 years
55% at 5 years
44% at 15 years
43% at 20 years
Significance and Relevance
This quantitative synthesis provides the first comprehensive overview of DCM's natural history, confirming a slow decline in neurological function. The derived formulae enable surgeons to communicate the risk of neurological deterioration to patients effectively, aiding shared decision-making. For spine surgeons and clinicians managing DCM, these findings offer valuable insights into disease progression and support informed patient counseling regarding conservative versus surgical management options.
Colby Oitment, Mohamed Sarraj, Philip Hache, Farid Foroutan, Travis E Marion, Daipayan Guha, Markian Pahuta
