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Few patients with neurodegenerative disorders require spinal surgery
Nancy E Epstein1, Malcolm Gottesman2
1Chief of Neurosurgical Spine and Education, Winthrop University Hospital, Mineola, NY, USA.
Surgical Neurology International
|May 21, 2014
Summary
Spinal surgery is rarely needed for patients with neurodegenerative disorders (ND). Second opinions are crucial, as many patients advised to have surgery were found to not require it.
Area of Science:
- Neurosurgery
- Neurology
- Spinal Disorders
Background:
- Few patients with neurodegenerative disorders (ND) require spinal surgery.
- Neurological symptoms often stem from the underlying disorder, not structural spinal pathology.
- Imaging like MRI and CT may show spinal issues unrelated to the primary neurological condition.
Purpose of the Study:
- To determine the frequency of spinal surgery recommendations for patients with ND.
- To evaluate the impact of second opinions on surgical recommendations for these patients.
Main Methods:
- A neurosurgeon reviewed 437 spinal consultations over 20 months.
- Analyzed patients seen in first opinion vs. second opinion.
- Included patients with Multiple Sclerosis (MS), Amyotrophic Lateral Sclerosis (ALS), and Postpolio Syndrome (PPS).
Main Results:
- Two of 11 patients (18%) with ND seen in first opinion required surgery.
- None of the seven patients with ND who sought a second opinion, having been recommended surgery previously, required an operation.
- This suggests second opinions can prevent unnecessary procedures.
Conclusions:
- Patients with neurodegenerative syndromes and reported spinal disease on imaging rarely need surgery.
- Exercise caution when recommending spinal surgery for ND patients.
- Encourage second opinions to avoid unnecessary surgical interventions.