Outcome and expansion rate of 57 XXXX managed nonoperatively.

@entity1 @entity2334 @entity397 @entity439 @entity1030 @entity1028 @entity1756
BACKGROUND: The prognosis of @entity2334 ( @entity2334 ) managed nonoperatively is unknown. @entity1 AND METHODS: To determine the risk of @entity397 and survival, we retrospectively reviewed the clinical course and computed tomographic data of 57 @entity1 who were evaluated for degenerative, nondissecting @entity2334 . Nonoperative management was decided initially for all @entity1 . Data of @entity439 expansion rate were available in 29 @entity1 who underwent 2 or more scans. Follow-up was complete in 52 (91%) @entity1 and averaged 37 months (range 1 to 82). RESULTS: Thirty-four of the 57 (60%) @entity1 died during follow-up, including 3 of 15 @entity1 who underwent subsequent repair of their @entity439 . Two- and 5-year survival rates for the entire group were 69% and 39%, with repair-free survival rates of 52% and 17%, respectively. Eight (14%) @entity1756 , accounting for 24% (8/34) of the deaths. Two- and 4-year risks of @entity397 were 12% and 32%, respectively. The median expansion rate was 0.2 cm/y and was greater in @entity1 with @entity1030 (P < 0.05). All @entity1756 were > 5 cm in diameter. @entity439 with a diameter > 5 cm at diagnosis had a higher @entity397 rate than those with a diameter < or = 5 cm (P < 0.05). Expansion rate did not predict @entity397 . CONCLUSIONS: Mortality of @entity1 with @entity2334 preselected for nonoperative management is high, with an overall survival rate of 39% and repair-free survival rate of only 17% at 5 years. Expansion rate of @entity2334 (0.2 cm/y) is similar to that of @entity1028 . Our data that support nonoperative management for @entity1 with @entity2334 < 5 cm in diameter, but confirm the increase rate of @entity397 for @entity439 > 5 cm.
