{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:50:18Z","timestamp":1786125018540,"version":"build-2736575974"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NEUROSURGERY","NEUROS"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>BACKGROUND:<\/jats:bold>\n                    Distinguishing the causes of weakness and gait instability in patients with Parkinson disease (PD) and cervical spondylotic myelopathy (CSM) is a diagnostic and therapeutic challenge due to symptomatic similarities. No study has reported outcomes following decompression in patients with PD and CSM.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>OBJECTIVE:<\/jats:bold>\n                    To report outcomes following cervical decompression for patients with coexisting PD and CSM.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>METHODS:<\/jats:bold>\n                    A retrospective matched cohort study of all patients with PD and CSM undergoing cervical decompression at a tertiary-care center between January 1996 and December 2014 was conducted. PD patients were matched to patients with CSM alone by age, gender, American Society of Anesthesiologists classification, and operative parameters. Myelopathy was assessed by Nurick and modified Japanese Orthopaedic Association (mJOA) scales. The effect of PD on mJOA was modeled using multivariable regression.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>RESULTS:<\/jats:bold>\n                    Twenty-one matched pairs were included. PD patients experienced poorer improvement in Nurick (0.0 vs \u20131.0,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; .01) and mJOA (0.9 vs 2.5,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; .01) composite scores. However, no significant changes in absolute improvement in the upper extremity motor, upper extremity sensory, or sphincter mJOA components were observed. Multivariable regression identified PD as a significant predictor of decreased improvement in mJOA (\u03b2 = \u20130.89,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; .01) and failure to achieve a minimal clinically important difference in change in mJOA (OR 0.18,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .03).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>CONCLUSION:<\/jats:bold>\n                    This study is the first to characterize outcomes following cervical decompression in patients with PD and CSM. PD patients experienced symptomatic improvement but less overall improvement in myelopathy compared to controls. However, PD patients demonstrated improvement in upper extremity motor, upper extremity sensory, and sphincter symptoms no worse than control patients.\n                  <\/jats:p>","DOI":"10.1093\/neuros\/nyw043","type":"journal-article","created":{"date-parts":[[2017,2,3]],"date-time":"2017-02-03T18:10:26Z","timestamp":1486145426000},"page":"350-356","source":"Crossref","is-referenced-by-count":14,"title":["Clinical Outcomes Following Surgical Management of Coexisting Parkinson Disease and Cervical Spondylotic Myelopathy"],"prefix":"10.1227","volume":"81","author":[{"given":"Roy","family":"Xiao","sequence":"first","affiliation":[{"name":"Center for Spine Health, Neurological Institute, Cleveland Clinic, Cleveland, Ohio"},{"name":"Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob A.","family":"Miller","sequence":"additional","affiliation":[{"name":"Center for Spine Health, Neurological Institute, Cleveland Clinic, Cleveland, Ohio"},{"name":"Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Lubelski","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Johns Hopkins Hospital, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas E.","family":"Mroz","sequence":"additional","affiliation":[{"name":"Center for Spine Health, Neurological Institute, Cleveland Clinic, Cleveland, Ohio"},{"name":"Department of Neurological Surgery, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward C.","family":"Benzel","sequence":"additional","affiliation":[{"name":"Center for Spine Health, Neurological Institute, Cleveland Clinic, Cleveland, Ohio"},{"name":"Department of Neurological Surgery, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajit A.","family":"Krishnaney","sequence":"additional","affiliation":[{"name":"Center for Spine Health, Neurological Institute, Cleveland Clinic, Cleveland, Ohio"},{"name":"Department of Neurological Surgery, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Machado","sequence":"additional","affiliation":[{"name":"Center for Spine Health, Neurological Institute, Cleveland Clinic, Cleveland, Ohio"},{"name":"Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,8]]},"reference":[{"issue":"14","key":"bib1-20231011","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1056\/NEJM2003ra020003","article-title":"Alzheimer's disease and Parkinson's disease","volume":"348","author":"Nussbaum","year":"2003","journal-title":"N Engl J Med"},{"issue":"6","key":"bib2-20231011","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/S1474-4422(06)70471-9","article-title":"Epidemiology of Parkinson's disease","volume":"5","author":"de Lau","year":"2006","journal-title":"Lancet Neurol"},{"issue":"4","key":"bib3-20231011","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1136\/jnnp.2007.131045","article-title":"Parkinson's disease: clinical features and diagnosis","volume":"79","author":"Jankovic","year":"2008","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"2","key":"bib4-20231011","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.pmr.2012.11.003","article-title":"Ambulation and Parkinson disease","volume":"24","author":"Amano","year":"2013","journal-title":"Phys Med Rehabil Clin N Am"},{"issue":"suppl I","key":"bib5-20231011","first-page":"S87","article-title":"Parkinson's disease: health-related quality of life, economic cost, and implications of early treatment","volume":"16","author":"Chen","year":"2010","journal-title":"Am J Manag Care"},{"issue":"1","key":"bib6-20231011","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.ncl.2012.09.003","article-title":"Cervical spondylotic myelopathy","volume":"31","author":"Toledano","year":"2013","journal-title":"Neurol Clin"},{"issue":"2","key":"bib7-20231011","doi-asserted-by":"crossref","first-page":"104","DOI":"10.3171\/2009.1.SPINE08716","article-title":"The natural history of cervical spondylotic myelopathy","volume":"11","author":"Matz","year":"2009","journal-title":"J Neurosurg Spine"},{"issue":"7","key":"bib8-20231011","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.2106\/JBJS.F.00014","article-title":"Operative treatment of cervical spondylotic myelopathy","volume":"88","author":"Rao","year":"2006","journal-title":"J Bone Joint Surg Am"},{"issue":"1","key":"bib9-20231011","doi-asserted-by":"crossref","first-page":"64","DOI":"10.3171\/jns.1997.86.1.0064","article-title":"Modified open-door cervical expansive laminoplasty for spondylotic myelopathy: operative technique, outcome, and predictors for gait improvement","volume":"86","author":"Lee","year":"1997","journal-title":"J Neurosurg"},{"issue":"22","key":"bib10-20231011","doi-asserted-by":"crossref","first-page":"2308","DOI":"10.1097\/00007632-199911150-00004","article-title":"Operative results of canal-expansive laminoplasty for cervical spondylotic myelopathy in elderly patients","volume":"24","author":"Tanaka","year":"1999","journal-title":"Spine"},{"issue":"suppl 1","key":"bib11-20231011","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.surneu.2005.02.016","article-title":"Cervical spondylotic myelopathy: 10 years of prospective outcome analysis of anterior decompression and fusion","volume":"64","author":"Chagas","year":"2005","journal-title":"Surg Neurol"},{"issue":"2","key":"bib12-20231011","doi-asserted-by":"crossref","first-page":"130","DOI":"10.3171\/2009.3.SPINE08728","article-title":"Cervical surgical techniques for the treatment of cervical spondylotic myelopathy","volume":"11","author":"Mummaneni","year":"2009","journal-title":"J Neurosurg Spine"},{"key":"bib13-20231011","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/S1529-9430(02)00566-1","article-title":"Cervical myelopathy: current diagnostic and treatment strategies","volume":"3","author":"Edwards","year":"2003","journal-title":"Spine J"},{"issue":"2","key":"bib14-20231011","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.ocl.2009.12.010","article-title":"Cervical spondylotic myelopathy: a review of the evidence","volume":"41","author":"Klineberg","year":"2010","journal-title":"Orthop Clin North Am"},{"issue":"7","key":"bib15-20231011","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1590\/S1807-59322009000700002","article-title":"Predictors of in-hospital mortality among older patients","volume":"64","author":"Silva","year":"2009","journal-title":"Clinics"},{"issue":"2","key":"bib16-20231011","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1227\/01.neu.0000316013.97926.4c","article-title":"Cervical spondylotic myelopathy: complications and outcomes after spinal fusion","volume":"62","author":"Boakye","year":"2008","journal-title":"Neurosurgery"},{"issue":"18","key":"bib17-20231011","doi-asserted-by":"crossref","first-page":"2006","DOI":"10.1097\/01.brs.0000138306.02425.21","article-title":"Spinal surgery in patients with Parkinson's disease: construct failure and progressive deformity","volume":"29","author":"Babat","year":"2004","journal-title":"Spine"},{"issue":"3","key":"bib18-20231011","doi-asserted-by":"crossref","first-page":"E5","DOI":"10.3171\/2010.1.FOCUS09288","article-title":"Spinal deformity and Parkinson disease: a treatment algorithm","volume":"28","author":"Upadhyaya","year":"2010","journal-title":"Neurosurg Focus"},{"issue":"10","key":"bib19-20231011","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1007\/s00586-010-1405-y","article-title":"Spinal surgery in patients with Parkinson's disease: experiences with the challenges posed by sagittal imbalance and the Parkinson's spine","volume":"19","author":"Koller","year":"2010","journal-title":"Eur Spine J"},{"issue":"7","key":"bib20-20231011","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1097\/BSD.0b013e318224a625","article-title":"Surgical outcome of lumbar fusion surgery in patients with Parkinson disease","volume":"25","author":"Moon","year":"2012","journal-title":"J Spinal Disord Tech"},{"key":"bib21-20231011","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1097\/00002517-199109000-00005","article-title":"Cervical laminectomy and dentate ligament section for cervical spondylotic myelopathy","volume":"4","author":"Benzel","year":"1991","journal-title":"J Spinal Disord"},{"key":"bib22-20231011","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1093\/brain\/95.1.87","article-title":"The pathogenesis of the spinal cord disorder associated with cervical spondylosis","volume":"95","author":"Nurick","year":"1972","journal-title":"Brain"},{"issue":"12","key":"bib23-20231011","doi-asserted-by":"crossref","first-page":"2096","DOI":"10.1007\/s00586-007-0512-x","article-title":"Analysis of five specific scores for cervical spondylogenic myelopathy","volume":"16","author":"Vitzthum","year":"2007","journal-title":"Eur Spine J"},{"key":"bib24-20231011","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1186\/1471-2474-8-111","article-title":"Design of Lamifuse: a randomised, multi-centre controlled trial comparing laminectomy without or with dorsal fusion for cervical myeloradiculopathy","volume":"8","author":"Bartels","year":"2007","journal-title":"BMC Musculoskelet Disord"},{"issue":"2","key":"bib25-20231011","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.spinee.2013.11.012","article-title":"Clinical outcomes following surgical management of coexistent cervical stenosis and multiple sclerosis: a cohort-controlled analysis","volume":"14","author":"Lubelski","year":"2014","journal-title":"Spine J"}],"container-title":["Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/neurosurgery\/article-pdf\/81\/2\/350\/32600755\/nyw043.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/00006123-201708000-00017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:48:58Z","timestamp":1786121338000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00006123-201708000-00017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2,2]]},"references-count":25,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.1093\/neuros\/nyw043","relation":{},"ISSN":["0148-396X","1524-4040"],"issn-type":[{"value":"0148-396X","type":"print"},{"value":"1524-4040","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,2,2]]}}}