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Karabacak M, Jagtiani P, Zipser CM, Tetreault L, Davies B, Margetis K. Mapping the Degenerative Cervical Myelopathy Research Landscape: Topic Modeling of the Literature. Global Spine J 2024:21925682241256949. [PMID: 38760664 DOI: 10.1177/21925682241256949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2024] Open
Abstract
STUDY DESIGN Topic modeling of literature. OBJECTIVES Our study has 2 goals: (i) to clarify key themes in degenerative cervical myelopathy (DCM) research, and (ii) to evaluate the current trends in the popularity or decline of these topics. Additionally, we aim to highlight the potential of natural language processing (NLP) in facilitating research syntheses. METHODS Documents were retrieved from Scopus, preprocessed, and modeled using BERTopic, an NLP-based topic modeling method. We specified a minimum topic size of 25 documents and 50 words per topic. After the models were trained, they generated a list of topics and corresponding representative documents. We utilized linear regression models to examine trends within the identified topics. In this context, topics exhibiting increasing linear slopes were categorized as "hot topics," while those with decreasing slopes were categorized as "cold topics". RESULTS Our analysis retrieved 3510 documents that were classified into 21 different topics. The 3 most frequently occurring topics were "OPLL" (ossification of the posterior longitudinal ligament), "Anterior Fusion," and "Surgical Outcomes." Trend analysis revealed the hottest topics of the decade to be "Animal Models," "DCM in the Elderly," and "Posterior Decompression" while "Morphometric Analyses," "Questionnaires," and "MEP and SSEP" were identified as being the coldest topics. CONCLUSIONS Our NLP methodology conducted a thorough and detailed analysis of DCM research, uncovering valuable insights into research trends that were otherwise difficult to discern using traditional techniques. The results provide valuable guidance for future research directions, policy considerations, and identification of emerging trends.
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Affiliation(s)
- Mert Karabacak
- Department of Neurosurgery, Mount Sinai Health System, New York, NY, USA
| | - Pemla Jagtiani
- School of Medicine, SUNY Downstate Health Sciences University, New York, NY, USA
| | - Carl Moritz Zipser
- Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland
| | - Lindsay Tetreault
- Department of Neurology, New York University Langone, New York, NY, USA
| | - Benjamin Davies
- Department of Clinical Neurosurgery, University of Cambridge, Cambridge, UK
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Evaniew N, Bailey CS, Rampersaud YR, Jacobs WB, Phan P, Nataraj A, Cadotte DW, Weber MH, Thomas KC, Manson N, Attabib N, Paquet J, Christie SD, Wilson JR, Hall H, Fisher CG, McIntosh G, Dea N. Anterior vs Posterior Surgery for Patients With Degenerative Cervical Myelopathy: An Observational Study From the Canadian Spine Outcomes and Research Network. Neurosurgery 2024:00006123-990000000-01041. [PMID: 38305343 DOI: 10.1227/neu.0000000000002842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/29/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The advantages and disadvantages of anterior vs posterior surgical approaches for patients with progressive degenerative cervical myelopathy (DCM) remain uncertain. Our primary objective was to evaluate patient-reported disability at 1 year after surgery. Our secondary objectives were to evaluate differences in patient profiles selected for each approach in routine clinical practice and to compare neurological function, neck and arm pain, health-related quality of life, adverse events, and rates of reoperations. METHODS We analyzed data from patients with DCM who were enrolled in an ongoing multicenter prospective observational cohort study. We controlled for differences in baseline characteristics and numbers of spinal levels treated using multivariable logistic regression. Adverse events were collected according to the Spinal Adverse Events Severity protocol. RESULTS Among 559 patients, 261 (47%) underwent anterior surgery while 298 (53%) underwent posterior surgery. Patients treated posteriorly had significantly worse DCM severity and a greater number of vertebral levels involved. After adjusting for confounders, there was no significant difference between approaches for odds of achieving the minimum clinically important difference for the Neck Disability Index (odds ratio 1.23, 95% CI 0.82 to 1.86, P = .31). There was also no significant difference for change in modified Japanese Orthopedic Association scores, and differences in neck and arm pain and health-related quality of life did not exceed minimum clinically important differences. Patients treated anteriorly experienced greater rates of dysphagia, whereas patients treated posteriorly experienced greater rates of wound complications, neurological complications, and reoperations. CONCLUSION Patients selected for posterior surgery had worse DCM and a greater number of vertebral levels involved. Despite this, anterior and posterior surgeries were associated with similar improvements in disability, neurological function, pain, and quality of life. Anterior surgery had a more favorable profile of adverse events, which suggests it might be a preferred option when feasible.
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Affiliation(s)
- Nathan Evaniew
- University of Calgary Spine Program, University of Calgary, Calgary, Alberta, Canada
| | - Christopher S Bailey
- London Health Science Centre Combined Orthopaedic and Neurosurgery Spine Program, Schulich School of Medicine, Western University, London, Ontario, Canada
| | - Y Raja Rampersaud
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - W Bradley Jacobs
- University of Calgary Spine Program, University of Calgary, Calgary, Alberta, Canada
| | - Philippe Phan
- Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Andrew Nataraj
- Division of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada
| | - David W Cadotte
- University of Calgary Spine Program, University of Calgary, Calgary, Alberta, Canada
| | - Michael H Weber
- Division of Orthopaedics, McGill University, Montreal, Quebec, Canada
| | - Kenneth C Thomas
- University of Calgary Spine Program, University of Calgary, Calgary, Alberta, Canada
| | - Neil Manson
- Canada East Spine Centre, Saint John, New Brunswick, Canada
| | | | - Jerome Paquet
- Department of Orthopaedics, Centre Hospitalier, Universitaire de Quebec, Quebec, Quebec, Canada
| | - Sean D Christie
- Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Hamilton Hall
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Charles G Fisher
- Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Nicolas Dea
- Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, British Columbia, Canada
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Du W, Wang HX, Lv J, Wang S, Shen Y, Zhang X, Chen R, Zhang L. Cervical alignment and clinical outcome of anterior cervical discectomy and fusion vs. anterior cervical corpectomy and fusion in local kyphotic cervical spondylotic myelopathy. Heliyon 2023; 9:e19106. [PMID: 37636480 PMCID: PMC10450976 DOI: 10.1016/j.heliyon.2023.e19106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 08/07/2023] [Accepted: 08/10/2023] [Indexed: 08/29/2023] Open
Abstract
Background Cervical local kyphosis (CLK) is a common degenerative disorder with a potentially debilitating and intractable condition. Currently, there is still debate on the optimal treatment of local kyphotic cervical spondylotic myelopathy (LKCSM) via different anterior approaches. Objective The objective of this study was to evaluate the surgical efficacy of anterior cervical discectomy and fusion (ACDF) vs. anterior cervical corpectomy and fusion (ACCF) for the treatment of LKCSM. In addition, the cervical sagittal alignment parameters and axial symptoms (AS) severity after CLK correction were analyzed. Materials and methods From January 2016 and December 2020, 104 patients who suffered LKCSM were retrospectively reviewed. These patients underwent ACDF (n = 53) and ACCF (n = 51). Pre- and postoperatively, cervical sagittal alignment parameters were measured on the lateral X-rays, including local kyphotic angles (LKA), C2-7 Cobb angle, T1 slope, and C2-7 sagittal vertical axis (C2-7 SVA). The neurological recovery rate was calculated according to the Japanese Orthopedic Association (JOA) score. The AS severity was evaluated using Neck Disability Index (NDI). Results Significant differences (P < 0.05) were demonstrated between ACDF and ACCF groups regarding LKA, LKA correction, C2-7 Cobb angle, T1 slope, C2-7 SVA, NDI, NDI recovery and NDI ranking system. However, no significant differences (P > 0.05) existed in JOA score, recovery rate, and neurological recovery rate grade. In both groups, significant differences (P < 0.05) were demonstrated between pre- and postoperative LKA, T1 slope, C2-7 Cobb angle, C2-7 SVA, JOA score, and NDI. LKA correction showed the positive correlations with the recovery rate (r = 0.48, P < 0.001), and with the NDI recovery in ACDF group (r = 0.49, P < 0.001) and in ACCF group (r = 0.55, P < 0.001). Conclusions LKCSM with ≤3 segments of spinal cord compression can be improved with either ACDF or ACCF, resulting in satisfactory neurological outcomes. CLK correction can significantly improve the neurological function and AS, and increase the T1 slope and C2-7 SVA. However, ACDF was more favorable than ACCF in the CLK correction.
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Affiliation(s)
- Wei Du
- Department of Orthopedics, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, China
| | - Hai-Xu Wang
- Department of Orthopedics, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, China
| | - Jie Lv
- Department of Oral and Maxillofacial Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, China
| | - Shuai Wang
- Department of Orthopedics, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, China
| | - Yong Shen
- Department of Orthopedics, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, China
| | - Xu Zhang
- Department of Orthopedics, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, China
| | - Rong Chen
- Department of Neurology, Hebei Key Laboratory of Vascular Homeostasis and Hebei Collaborative Innovation Center for Cardio-cerebrovascular Disease, The Second Hospital of Hebei Medical University, 215 Hepingxi Road, 050000, Shijiazhuang, China
| | - Li Zhang
- Department of Orthopedics, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, China
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