Change in Impairment following Operative Treatment of Degenerative Cervical Myelopathy: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Introduction The primary objective of this work was to define the neurological benefit conferred by surgical intervention to patients with degenerative cervical myelopathy (DCM). Secondary objectives included assessing how preoperative disease severity and duration impacted on that benefit and defining the surgical complications encountered by these patients. Material and Methods A search was undertaken for articles published until May 2015 evaluating the operative treatment of DCM using electronic databases. Prospective studies of adult surgical myelopathic patients were included. Extracted data included study design, patient demographics, diagnosis, surgical approach, preoperative and postoperative neurological status (mJOA, NDI, Nurick, VAS), and complications. Preoperative disease severity and duration of symptoms were recorded. Risk of bias (Newcastle-Ottawa Scale) and quality of evidence (Grades of Recommendation Assessment, Development and Evaluation) were assessed. Primary outcomes included assessment of change in neurological (graded by mJOA, NDI, and Nurick scores) and pain (graded by VAS score) following surgical intervention for myelopathic patients. Secondary outcomes were also assessed for dependency on preoperative duration of symptoms and preoperative disease severity. Safety of surgery was assessed by pooled estimates of perioperative complications encountered. Results Among 32 included studies, surgical intervention for DCM patients provided clinically-significant improvement in neurological dysfunction and pain. This improvement occurred at short-term assessment (fewer than 12 months) and was durable in longer-term (greater than 36 months), consistent over several different scoring systems. Shorter duration of symptoms may be associated with a higher likelihood of neurological recovery. Conclusion Surgical intervention for DCM is an appropriate evidence-based therapy with an acceptably low rate of perioperative complication. Further work is important to define optimal surgical approach and timing.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.043 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.015 | 0.032 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".