Patients with cervical myelopathy have a significantly higher risk of sustaining falls, lower extremity fractures and head injuries compared with patients who do not have cervical myelopathy, Parkinson’s disease or vestibular disease, according to results of a retrospective national database study presented here.
Myelopathy gait is one of the most common presenting symptoms of a patient with cervical myelopathy, Daniel J. Blizzard, MD, said at the Cervical Spine Research Society Annual Meeting. The abnormal gait leads to a higher risk of serious falls and injuries.
“The symptoms of myelopathy may be insidious or masked, and patients can often attribute these to normal effects of aging. Often, a primary care physician will not recognize these initial symptoms, especially if there is another confounding presenting complaint,” Blizzard said at the meeting.
Blizzard and colleagues used the PearlDiver database to identify 601,390 patients who had cervical myelopathy with data entered between 2005 and 2011. The researchers also used the database to identify 35,997,166 control patients who did not have cervical myelopathy, Parkinson’s disease or vestibular disease with data entered during the same period.
Blizzard said patients with cervical myelopathy had a statistically significant increased risk for all complications compared with the control group including falls, hip fractures, leg and ankle fractures, femur fractures and head injuries. Falling incidents (11.3%) were higher for cervical myelopathy patients compared with the control group.
The researchers found a subset of 77,346 patients who had cervical myelopathy and subsequently underwent cervical decompression surgery with or without fusion. These patients had a significant reduction in falls, head injuries, skull fractures, and leg and ankle fractures with risk ratios of 0.83, 0.87, 0.78 and 0.88, respectively. However, a significant decrease in hip, pelvis and femur fractures was not evident, Blizzard noted.
Blizzard DJ, et al. Presentation #58. Presented at: Cervical Spine Research Society Annual Meeting; Dec. 3-5, 2015; San Diego.
Disclosure: Blizzard reports no relevant financial disclosures.