1505. Characteristics of Blood Parameters and Prevalence of Anemia in Patients with Degenerative Cervical Myelopathy: A Retrospective Study of 2 Spine Centers
Authors: Aria Nouri; Nora Elson; Zach Pennington; Abhijith Matur; Sakib Huq; Karim Ahmed; Kishan Patel; Rani Nasser; Daniel Sciubba; Joseph Cheng (Cincinnati, OH)
Degenerative Cervical Myelopathy (DCM) is most commonly present in patients in their 5th decade and it is known that anemia due to nutritional deficiencies such as B12 are common among this patient population. Herein, we report the prevalence and association between anemia and DCM.
Charts for patients undergoing surgery for DCM were retrospectively reviewed at 2 academic spine centers, with the earliest surgery performed October 2012. Patient demographics, surgical procedure and preoperative blood measurements including hemoglobin (Hgb), hematocrit, CBC, mean cell Hgb were collected. MCV≥100 was used to identify patients with macrocytic anemia, and patients with 100>MCV≥96 were considered to have borderline macrocytic anemia. Microcytic anemia was considered in patients with MCV<80.
The cohort included 912 patients, 493 males (54.1%) and 419 females (45.9%), with an average age of 56.5 years (19-90). The average blood values were, HCT = 39.65, MCHC = 33.41, MCV = 90.05, HGB = 13.15, RDW = 14.07, RBC = 4.42, WBC = 9.93. Macrocytic anemia was present in 20 patients 3.0% (20/660), and borderline macrocytic anemia was present in 7.7% (51/660). Microcytic anemia was present in 4.4% (29/660) of patients. There were no statistical differences in the presence of anemia and sex or age. However, patients with microcytic anemia were disproportionately younger (mean 53.6years) than those with macrocytic anemia (mean 59.6years).
Both microcytic and macrocytic anemia are common in patients with DCM, being present in more than 10% of patients preoperatively. Anemia is known to impact surgical outcomes but the common presence of frank and borderline macrocytic anemia is particularly concerning as it may indicate an underlying B12 deficiency, which is not only a differential diagnosis for DCM but also is necessary for myelination and neurological function.