Spinal cord damage to the cervical spine, also known as cervical myelopathy, is common in old age and can cause gait instability and consecutive falls, among other things. We still know little about how often this spinal cord damage occurs in older patients with gait instability without the patients realizing it. According to small studies, it is around 18% of patients with femoral neck fractures following falls. With our study we want to find out whether it would be beneficial to perform a preliminary examination for cervical myelopathy in elderly patients with gait instability in order to prevent potential falls.

This is a prospective monocentric study that will take place at the Clinics for Orthopaedics and Traumatology and Spinal Surgery at the University Hospital Basel. We will include approximately 200 patients over 70 years of age with a femoral neck fracture after a fall.

§ We are conducting this study in accordance with Swiss law. In addition, we are observing all internationally recognized guidelines. The responsible ethics committee has reviewed and approved the study.

§ A description of this study can also be found on the website of the Federal Office of Public Health at www.kofam.ch

Dr. Olga Krupkova obtained her PhD in musculoskeletal biology at ETH Zurich and continued her postdoctoral research in the intervertebral disc (IVD) field at the University of Zurich, ETH Zurich, and University Hospital Basel. During her career, she identified new therapeutic targets and anti-inflammatory compounds for the treatment of degenerative disc disease (DDD), followed by research on nano-/microencapsulation and drug delivery into the IVD. Her work focuses on the development of disease-mimicking models and advanced therapies (microenvironment-resistant cell therapy, CRISPR/dCas9, personalized approach). To date, OK has received multiple third-party grants and authored a number of publications in international peer-reviewed journals. 

We welcome motivated students and researchers to work in our team. For more details about available projects please contact olga.krupkova@usb.ch

If you decide to take part, you will need to have a magnetic resonance imaging (MRI) of the cervical spine, a clinical neurological examination and, if necessary, an electrophysiological examination. This will not change the treatment in any way.

1. Hospitalization with study visit.

2. An MRI of the cervical spine. This usually takes about 20 minutes. If the findings are normal, no further study examinations or interviews are planned.

3. If a narrowing of the spinal canal with/without spinal cord damage is detected: Approximately 12 weeks after discharge and after you have recovered from the operation, you will be asked to attend our spinal surgery consultation. You will undergo a neurological examination to detect signs of spinal cord damage and an electrophysiological examination using MEP and SSEP. We will also ask you questions about your ability to walk before the fall. This usually takes about 30 minutes. Your general practitioner will be informed about your participation in the study.

Duration: One to two visits during the inpatient stay, in addition to the normal post-operative follow-up checks by the colleagues in traumatology (6, 12, 52 weeks after surgery), additional clinical assessment by spinal surgery (neurological examination) and neurology (electrophysiological examination) after 12 weeks (if possible, on the same date as the traumatology check-up). A total of 1 year study participation. Recruitment will most likely start in November 2022, data will most likely be analyzed 3 years later.