{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T13:22:05Z","timestamp":1793366525989,"version":"4.5.0"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>This study aimed to determine the age- and sex-specific incidence of cervical spondylotic myelopathy (CSM) and its associated risk of causing subsequent spinal cord injury (SCI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the National Health Insurance Research Database (NHIRD), a 12-year nationwide database in Taiwan, this retrospective cohort study analyzed the incidence of hospitalization caused by CSM. All patients diagnosed with and admitted for CSM were identified during the study period. The CSM patients were divided into 2 groups, a control group and an operated group. An incidence density method was used to estimate age- and sex-specific incidence rates of CSM. The Kaplan-Meier method and Cox regression analyses were performed to compare the risk of SCI between the 2 groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 1998 to 2009, covering 349.5 million person-years, 14,140 patients were hospitalized for CSM. The overall incidence of CSM-related hospitalization was 4.04 per 100,000 person-years. Specifically, males and older persons had a higher incidence rate of CSM. During the follow-up of these patients for 13,461 person-years, a total of 166 patients were diagnosed with SCI. The incidence of SCI was higher in the control group than the operated group (13.9 vs 9.4 per 1000 person-years, respectively). During the follow-up, SCI was more likely to occur in CSM patients who were treated conservatively (crude HR 1.48, p = 0.023; adjusted HR 1.57, p = 0.011) than in those who underwent surgery for CSM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a national cohort of eastern Asia, the incidence of CSM-caused hospitalization was 4.04 per 100,000 person-years, with higher incidences observed in older and male patients. Subsequent SCI was more likely to develop in patients who received nonoperative management than in those who underwent surgery. Therefore, patients with CSM managed without surgery should be cautioned about SCI. However, further investigations are still required to clarify the risks and complications associated with surgery for CSM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2013.4.focus13122","type":"journal-article","created":{"date-parts":[[2013,7,1]],"date-time":"2013-07-01T09:58:16Z","timestamp":1372672696000},"page":"E10","source":"Crossref","is-referenced-by-count":180,"title":["Epidemiology of cervical spondylotic myelopathy and its risk of causing spinal cord injury: a national cohort study"],"prefix":"10.3171","volume":"35","author":[{"given":"Jau-Ching","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei;"},{"name":"School of Medicine,"},{"name":"Institute of Pharmacology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin-Chu","family":"Ko","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei;"},{"name":"School of Medicine,"},{"name":"Institute of Pharmacology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Shu","family":"Yen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei;"},{"name":"School of Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Cheng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei;"},{"name":"School of Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Chun","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Medicine,"},{"name":"Department of Medical Research and Education, National Yang-Ming University Hospital, I-Lan;"},{"name":"Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan; and"},{"name":"College of Medicine, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsung-Hsi","family":"Tu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei;"},{"name":"School of Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su-Shun","family":"Lo","sequence":"additional","affiliation":[{"name":"School of Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrich","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei;"},{"name":"School of Medicine,"},{"name":"Institute of Pharmacology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1 Suppl 1","key":"b1-0350010","series-title":"Neurosurgery","first-page":"S35","article-title":"Cervical spondylotic myelopathy: a brief review of its pathophysiology, clinical course, and diagnosis","volume":"60","author":"Baron","year":"2007"},{"key":"b2-0350010","series-title":"Scientometrics","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1007\/s11192-010-0289-2","article-title":"Taiwan's national health insurance research database: administrative health care database as study object in bibliometrics","volume":"86","author":"Chen","year":"2011"},{"key":"b3-0350010","series-title":"Pharmacoepidemiol Drug Saf","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1002\/pds.2087","article-title":"Validation of the national health insurance research database with ischemic stroke cases in Taiwan","volume":"20","author":"Cheng","year":"2011"},{"key":"b4-0350010","series-title":"Eur Spine J","article-title":"Measurement of volume-occupying rate of cervical spinal canal and its role in cervical spondylotic myelopathy","author":"Dong","year":"2013"},{"key":"b5-0350010","series-title":"Arch Orthop Trauma Surg","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1007\/BF00441836","article-title":"Cervical spinal cord injury associated with ossification of the posterior longitudinal ligament","volume":"113","author":"Endo","year":"1994"},{"key":"b6-0350010","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2730","DOI":"10.1097\/00007632-199812150-00012","article-title":"A review of the pathophysiology of cervical spondylotic myelopathy with insights for potential novel mechanisms drawn from traumatic spinal cord injury","volume":"23","author":"Fehlings","year":"1998"},{"issue":"323","key":"b7-0350010","series-title":"Clin Orthop Relat 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