The team looked at past medical records and matched together 21 pairs of patients. In each pair, the patients’ age, gender, anaesthetic classification, and operative parameters were the same. The only difference: one of each pair had CSM while the other had CSM and PD. All patients underwent decompressive spinal surgery for their CSM. The researchers subsequently followed-up the patients to see how they fared after surgery. They found that patients with CSM and PD showed similar improvement to CSM patients for most areas; upper limb function, sensory disturbance, and bladder function. However, not with lower limb function. Additionally, overall, patients with PD were less likely to achieve what is referred to as a minimum clinically important difference, i.e. an improvement that is deemed to be worth while.
So, what does this all mean? Well, despite the study’s small sample size, this work suggests that patients with both CSM and PD can benefit from standard CSM surgery, although not always and not to the same extent as those with just CSM. Ultimately, this study calls for further research looking at the interplay between PD and CSM. As in order to best treat patients, CSM doctors must be able to discern the major culprit for the patients’ symptoms and advise patients accurately whether they would benefit from surgery (which is not without risk).
1) Xiao et al. Clinical Outcomes Following Surgical Management of Coexisting Parkinson Disease and Cervical Spondylotic Myelopathy. Neurosurgery Feb 2017
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