Faculty Collaboration Database

Impact of postsurgical rehabilitation on outcomes for degenerative cervical myelopathy. J Neurosurg Spine 2024 Aug 01;41(2):167-173

Date

05/10/2024

Pubmed ID

38728769

DOI

10.3171/2024.2.SPINE231170

Scopus ID

2-s2.0-85200524767 (requires institutional sign-in at Scopus site)

Abstract

OBJECTIVE: Despite widespread use, there is limited evidence to support postsurgical rehabilitation to enhance neurological recovery after surgery for degenerative cervical myelopathy (DCM). Outcomes research for DCM seldom accounts for the effect of postsurgical rehabilitation. The aim of this study was to quantify the impact of postsurgical rehabilitation on outcomes after surgery for DCM.

METHODS: This was a retrospective analysis of prospectively collected data from a single center. The study enrolled 66 patients who underwent spinal surgery for DCM. In addition to patient demographic, imaging, and surgical data, chart review was performed to document the timing, type, duration, and outcomes of postsurgical rehabilitation therapy. Outcomes were collected prospectively, including the modified Japanese Orthopaedic Association (mJOA) score, Neck Disability Index (NDI) score, and SF-36 physical component summary (PCS) score. Linear regression models were created to determine the independent effects of type and timing of postsurgical occupational therapy (OT) and physical therapy (PT) on outcomes.

RESULTS: A total of 66 patients were included in the analysis. Multivariate regression analysis showed that postsurgical OT was associated with significantly greater improvement in 12-month SF-36 PCS scores (p = 0.009) and mJOA scores (p = 0.019). In the subset of patients who received therapy, delayed therapy (> 42 days after surgery) compared to early therapy (< 42 days after surgery) was associated with less improvement in SF-36 PCS scores (p = 0.03).

CONCLUSIONS: Postsurgical outpatient rehabilitation was independently associated with improved postsurgical outcomes within the 1st year after surgery for DCM, and early therapy (< 42 days) was associated with superior outcomes compared to delayed therapy. This is one of the first studies to use a prospective database to demonstrate an independent effect for postsurgical rehabilitation on outcomes after surgery for DCM.

Author List

Rahman M, Banerjee A, Yang Y, Annyapu E, DeGroot AL, Best B, Braza DW, Wang MC, Vedantam A

Authors

Anjishnu Banerjee PhD Associate Professor in the Data Science Institute department at Medical College of Wisconsin
Diane W. Braza MD Professor in the Physical Medicine and Rehabilitation department at Medical College of Wisconsin
Marjorie Wang MD Clinical Transformation Officer, Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Cervical Vertebrae
Disability Evaluation
Female
Humans
Male
Middle Aged
Physical Therapy Modalities
Prospective Studies
Retrospective Studies
Spinal Cord Diseases
Treatment Outcome