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 language | English |
|---|---|
| Pages (from-to) | 47-52 |
| Number of pages | 6 |
| Journal | Canadian Journal of Neurological Sciences |
| Volume | 34 |
| Issue number | 1 |
| State | Published - Feb 1 2007 |
| Externally published | Yes |
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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 journal › Article
}
TY - JOUR
T1 - Clinical equipoise and treatment decisions in cervical spondylotic myelopathy
AU - Benatar, Michael G
PY - 2007/2/1
Y1 - 2007/2/1
N2 - 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.
AB - 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.
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M3 - Article
C2 - 17352346
AN - SCOPUS:33947274000
VL - 34
SP - 47
EP - 52
JO - Canadian Journal of Neurological Sciences
JF - Canadian Journal of Neurological Sciences
SN - 0317-1671
IS - 1
ER -