New treatment for 'arthritis of the spine' prevents paralysis

Public release date: 18-Sep-2013 [ | E-mail | Share ]

Contact: Alexa Giorgi alexa.giorgi@uhn.ca 416-603-5800 x6776 University Health Network

Toronto, Canada (September 18, 2013) In a world-first, decompression surgery has been shown to be an effective procedure to treat cervical spondylotic myelopathy (CSM) a common progressive, degenerative disease of the spine that can lead to paralysis according to the results of a multi-centre clinical trial published today.

The study, with its use of multiple outcome measures to determine patient improvement, is the first research of its kind to show that decompression surgery has a significant improvement in both the symptoms and quality of life of CSM patients at all levels of severity.

The study, "Efficacy and Safety of Surgical Decompression in Patients with Cervical Spondylotic Myelopathy: Results of the AOSpine North America Prospective Multi-Center Study," published in the Journal of Bone and Joint Surgery, found that patients with mild, moderate and severe CSM show significant recovery after undergoing decompression surgery a procedure that alleviates pressure on the nerves of the spinal cord.

"The results of this trial support the use of decompression surgery as a viable treatment for Cervical Spondylotic Myelopathy and could lead to a change in practice to treat this condition," said Dr. Michael Fehlings, neurosurgeon and Medical Director of the Krembil Neuroscience Centre, Toronto Western Hospital and the study's lead author. "With few existing interventions available for these patients, it is encouraging to have data showing improvements in quality of life as a result of surgery, in some cases, even reversing serious neurological damage that could have resulted in paralysis."

To date, the limited research and mixed reports have concluded that there was no added benefit from surgical intervention for CSM patients, and that the best approach was to monitor the progression of their condition and, in some cases, treat conservatively with non-surgical approaches. However, in 30 to 50 per cent of CSM cases, it has been observed that the condition gets progressively worse, impairing patients' ability to walk and perform daily tasks such as dressing themselves and performing their own personal hygiene. This study clearly shows that many more patients with CSM could benefit from surgery than previously thought.

CSM is the leading cause of spinal cord dysfunction in the world, mostly affects people over the age of 50 and is very common in people of Asian and South Asian descent. Over time, the normal process of aging can sometimes lead to the narrowing of the spinal canal creating pressure on the spinal cord. As CSM progresses, it can cause neck stiffness, arm pain, numbness in the hands and, in severe cases, inhibits movement in limbs, impairs walking and can eventually lead to paralysis.

An unrecognized condition that is often misdiagnosed, CSM incidence and prevalence remain undetermined in Canada but, based on clinical caseloads and statistics from the U.S., is estimated to occur among 20 per cent of Canadians with approximately 10 per cent of them requiring surgery to treat the spinal cord dysfunction.

Other than medication to alleviate pain caused by the condition, there are no treatments available for CSM patients and surgery was usually only considered for the most severe cases in an attempt to stop further neurological deterioration.

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New treatment for 'arthritis of the spine' prevents paralysis