Open AccessPrognostic Indices of Surgical Outcome in Cervical Spondylotic Myelopathy: A Clinical Prospective Study
Author(s) -
Ahmed A. Marei,
Mohamed Reda Rady,
Hanan Kamal,
William C. Welch,
M. Hafez
Publication year - 2021
Publication title -
open access macedonian journal of medical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.288
H-Index - 17
ISSN - 1857-9655
DOI - 10.3889/oamjms.2021.6009
Subject(s) - medicine , magnetic resonance imaging , neurosurgery , orthopedic surgery , surgery , myelopathy , cord , spinal cord , prospective cohort study , radiology , psychiatry
BACKGROUND: One of the most common causes of spinal cord dysfunction is cervical spondylotic myelopathy (CSM) especially in the elderly. Prognostic indices can aid the surgeon preoperatively to detect the patients’ prognosis.AIM: The aim of the work is to better assess patients and to find possible indicators for post-operative improvement or deterioration in CSM patients.METHODS: Forty patients with multiple levels CSM, admitted and operated on in the Neurosurgery Department of Cairo University Hospitals, have been enrolled randomly in this study after fulfilling the criteria for CSM surgical intervention. The patient age, complaint duration, number of levels affected, signal intensity on T1-weighted and T2-weighted magnetic resonance (MR) images, Japan Orthopedic Association (JOA) scoring system, and Nurick’s score were evaluated before surgery and correlated with outcome after 1 year follow-up.RESULTS: About 80% of patients improved after operation with average pre- and post-operative JOA and Nurick scores about 11.23 and 3.12; 14.1 and 1.6, respectively. Patient age, sex, number of levels affected, and signal intensity on T1- weighted and T2-weighted MR images were not significantly associated with post-operative improvement, p > 0.05. However, the only significant prognostic factor was the duration of symptoms if less than 1 year with p < 0.05.CONCLUSION: Short complaint duration coupled with close intra-operative monitoring was directly correlated with good CMS operation outcome while age, sex, number of levels affected, presence of cord signal on MR imaging, and surgical approach appear to have no significant effect on outcome.