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The purpose of this interventional study is to determine the optimal surgical approach

(ventral vs. dorsal) for patients with multi-level cervical spondylotic myelopathy (CSM).

There are no established guidelines for the management of patients with CSM, which

represents the most common cause of spinal cord injury and dysfunction in the U.S. and

in the world.

This study, which began in April 2014, aims to test the hypothesis that ventral surgery

is associated with superior Short Form-36 Physical Component Score (SF-36 PCS)

outcome at one-year follow-up compared to dorsal approaches and that both ventral

and dorsal surgery improve symptoms of spinal cord dysfunction measured using the

modified Japanese Orthopedic Association Score (mJOA). A secondary hypothesis is

that health resource utilization for ventral surgery, dorsal fusion and laminoplasty

surgery are different. A third hypothesis is that cervical sagittal balance postoperatively

is a significant predictor of SF-36 PCS outcome. The study is expected to conclude

in September 2021. The final data collection date is September 2017 for the primary

outcome measure.


The EC-IC Bypass Study is a prospective registry evaluating EC-IC bypass for carotid

occlusion with persistent or unstable symptoms failing medical management. The study

is accruing patients from 11 centers, over three years with 24-month follow-up. Funds for

the project were donated by a patient and matched by the Wallace Foundation, which has

also committed funds for the development of a follow-up project, assessing mechanisms

to facilitate data transfer from the electronic medical records to the QOD.

“Every hospital should follow every patient it

treats long enough to determine whether the

treatment has been successful, and then inquire

‘if not, why not’ with a view to preventing similar

failures in the future.”

—Ernest Codman, 1914