Oral Presentation Sydney Spinal Symposium 2024

Degenerative Cervical Myelopathy Patients' six-month and twelve-month Follow-up Analysis from the MYelopathy NAtural History (MYNAH) Registry (107867)

Nashwa Najib 1 2 , Nancy Briggs 3 , Nickson Ning 3 , Richard Norman 4 , Alper Yataganbaba 5 , Prashanth Rao 6 , Ali Ghahreman 7 , Mitchell Hansen 8 , Ralph Mobbs 9 , Saeed Kohan 10 , Bhishampal Singh 11 , Ashish Diwan 1 2
  1. School of Clinical Medicine , University of New South Wales (UNSW), Sydney, NSW, Australia
  2. Spine Service, St George Hospital, Sydney, NSW, Australia
  3. Stats Central, Mark Wainwright Analytical Centre, University of New South Wales (UNSW), Sydney, NSW, Australia
  4. Curtin University, Perth, WA, Australia
  5. Royal Melbourne Hospital, Melbourne, VIC, Australia
  6. Brain and Spine Surgery, Norwest Private Hospital, Sydney, NSW, Australia
  7. Department of Neurosurgery, St George Hospital, Sydney, NSW, Australia
  8. Neurosurgery, Newcastle Private Hospital, Newcastle, NSW, Australia
  9. Neurospine Clinic, Sydney, NSW, Australia
  10. St George Hospital, Sydney, NSW, Australia
  11. NSW Spine Specialists, Sydney, NSW, Australia

Aims

This study aims to understand the natural history of Degenerative Cervical Myelopathy (DCM) and to compare the clinical and quality of life outcomes between the operated and non-operated participants.

Methods

The MYelopathy NAtural History (MYNAH) Registry (ACSQHC-ARCR-258) is Australia’s first observational registry for operative and non-operative DCM patients with follow-ups every six months. Patients are recruited via an opt-in approach and are eligible to participate if they have a clinical diagnosis of DCM by a spine/neurosurgeon. The Registry does not intervene in the surgeon’s management plan. Outcome variables are mJOA score, Nurick Grade, NDI, EQ-5D-5L and EQ-VAS. All statistical analysis was performed using Rv4.2.2 and SASv9.4.

Results

Participant recruitment is ongoing from eleven approved study sites across Australia. We included fifty participants (n=50) of which baseline data has been collected (100%), 6-month follow-up has been completed for 34 (68%) and 12-month follow-up for 18 (36%). Male participants are 31 (62%) and females are 19 (38%) with a mean age of 63 years (SD 13.6). At baseline, 18 participants have had a previous cervical spine surgery. No change in mJOA score was observed (p=NS). At 6-month follow-up, NDI among the non-operated group was found to be 25% less than compared to the operated group (p=NS) and this did not change at 12 months (p=NS). In the operated group, an improvement in Nurick grade by 53% and 55% was noted at 6-month and 12-month follow-ups respectively compared to the non-operated group (p=NS). In the operated group, EQ5D5L was found to be 14% and 18% lower compared to the non-operated group (p=NS) at 6-month and 12-month follow-ups, respectively. In the operated group, EQ-VAS was found to be 0.35% lower and 5.8% higher compared to the non-operated group (p=NS) at 6-month and 12-month follow-ups, respectively.

Conclusion

We have established a longitudinal clinical registry in Australia for subjects with DCM. This is an ongoing study and further analysis is needed with more follow-up time points for impactful results.