Clinical equipoise and treatment decisions in cervical spondylotic myelopathy

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective: The primary objective of this study is to evaluate clinician attitudes towards the treatment of cervical spondylotic myelopathy (CSM) in order to determine whether clinical equipoise exists for a segment of this patient population. The secondary objective is to examine the factors that influence treatment decisions. Methods: Cross-sectional internet-based survey of neurologists, neurosurgeons and orthopedic surgeons. Results: Between 40-60% of respondents recommended surgery for (1) patients with minimal or no symptoms, but incidentally discovered increased T2 signal within the cervical cord on MRI, (2) patients with mild symptoms and indentation of the cervical cord but without increased T2 signal and (3) those with at least moderately severe clinical findings accompanied by MRI showing effacement of the thecal sac but without indentation of the cord or increased T2 signal. The severity of the radiological abnormalities most strongly influence treatment decisions. Conclusions: We conclude that clinical equipoise does exist for certain groups of patients with CSM, suggesting that a randomized controlled trial could be performed in this population.

Original languageEnglish
Pages (from-to)47-52
Number of pages6
JournalCanadian Journal of Neurological Sciences
Volume34
Issue number1
StatePublished - Feb 1 2007
Externally publishedYes

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Spinal Cord Diseases
Therapeutics
Internet
Population
Randomized Controlled Trials
boldenone undecylenate
Surveys and Questionnaires
Cervical Cord

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Clinical equipoise and treatment decisions in cervical spondylotic myelopathy. / Benatar, Michael G.

In: Canadian Journal of Neurological Sciences, Vol. 34, No. 1, 01.02.2007, p. 47-52.

Research output: Contribution to journalArticle

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