(SS#II) Veena Mummaneni Award Winner: Women Demonstrate Significantly Greater Improvement in Neck Disability Index After Surgery for Cervical Myelopathy: An Analysis from the Quality Outcomes Database
Resident Physician University of California, San Francisco San Francisco, California, United States
Disclosure(s):
Arati Patel, MD: No financial relationships to disclose
Introduction: There is a high prevalence of cervical myelopathy that requires surgery; as such it is important to identify how different groups benefit from surgery. The AANS launched the Quality Outcomes Database prospective longitudinal registry that includes demographic, clinical, and patient-reported outcome data to measure the safety and quality of neurosurgical procedures. In this study we assess the impact of gender on patient reported outcomes in patients undergoing surgery for cervical myelopathy.
Methods: We analyzed 1152 patients undergoing surgery for cervical myelopathy in the Quality Outcomes Database (QOD) cervical module. A univariate comparison of baseline patient characteristics between males and females undergoing surgery for CSM was performed, with statistical significance determined by a two-sided Wilcoxon rank sum test. Baseline characteristics that significantly differed between males and females were included in a multivariable generalized linear model comparing baseline and 1-year postoperative Neck Disability Index (NDI) scores.
Results: This study included 546 females and 604 males. On multivariate analysis, females demonstrated a significantly greater improvement in NDI 1 year after surgery (p = 0.036). In addition to gender, the presence of axial neck pain and insurance status were also significantly predictive of improvement in NDI after surgery (p = 0.0013, and p = 0.0058 respectively). There was no significant difference in baseline NDI or NDI 1 year after surgery between the laminoplasty versus laminectomy/fusion group.
Conclusion : In the prospective QOD registry, we found females are more likely to benefit from surgery for cervical myelopathy compared to males. Interestingly, presence of preoperative axial neck pain and insurance status are also associated with improvements in NDI post operatively. It is important to both identify gender differences in pre-operative baseline characteristics and postoperative outcomes after surgery in order to deliver more personalized and patient-centric care.
