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Predictive factors for mild forms of spondylotic cervical myelopathy treated conservatively or surgically
Author(s) -
Kadaňka Z.,
Mareš M.,
Bednařík J.,
Smrčka V.,
Krbec M.,
Chaloupka R.,
Dušek L.
Publication year - 2005
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2004.00947.x
Subject(s) - medicine , surgery , myelopathy , spinal cord , conservative treatment , analysis of variance , randomized controlled trial , cervical vertebrae , psychiatry
A prospective 3‐year randomized study comparing conservative and surgical treatment of spondylotic cervical myelopathy to establish predictive factors for outcome after conservative treatment and surgery. The clinical, electrophysiological and imaging parameters were examined to reveal how they characterized the clinical outcome. Statistically, pair‐wise and multiple comparisons of different were used with the independent t ‐test and on one‐way anova models followed by Tukey multiple‐range tests. The patients with a good outcome in the conservatively treated group were of older age before treatment, had normal central motor conduction time (CMCT), and possessed a larger transverse area of the spinal cord. The patients with a good outcome in the surgically treated group had a more serious clinical picture (expressed in mJOA score and slower walk). Patients should rather be treated conservatively if they a spinal transverse area larger than 70 mm 2 , are of older age, and have normal CMCT. Surgery is more suitable for patients with clinically worse status and a lesser transverse area of spinal cord.