Neurosurgeons, neurologists most likely to diagnose cervical spondylotic myelopathy

Neurosurgeons and neurologists were more likely to diagnose patients with cervical spondylotic myelopathy at first visit compared with orthopedic surgeons and primary physicians, according to recent study results.

Researchers collected medical records of 42 patients who underwent surgery for cervical spondylotic myelopathy (CSM) at the Spine Unit of Tel-Aviv Medical Center between January 2009 and December 2010. Researchers also collected data from the time the first signs or symptoms of CSM were documented until the date of surgery, and conducted phone interviews with patients.

Study results showed that 69% of patients initially sought a diagnosis for their symptoms from family physicians and 21.4% from community-based orthopedic surgeons. Of the remaining patients, no one consulted a neurologist or neurosurgeon, the most likely to recognize the disease.

Most patients went to orthopedic surgeons (48.8%) and family physicians (26.8%) at their second physician visit. Only 9.8% saw neurologists and 2.4% saw neurosurgeons. Patients continued to consult orthopedic surgeons most frequently (38.5%) at their third physician visit; however, more patients sought out neurologists (25.6%) and neurosurgeons (18%). Only 12.8% of patients returned to family physicians.

Overall, the researchers found it took a mean of five physician visits to obtain the correct diagnosis of CSM, which was often made by neurosurgeons and neurologists, and less frequently by orthopedic surgeons, family physicians and a variety of other specialists.

For more information:

Behrbalk E. Neurosurgical Focus. 2013;doi:

Disclosure: The researchers have no relevant financial disclosures.

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