Prognostic Factors in Cervical Spondylotic Myelopathy: A Clinical Prospective Study. Issue 1 (February 2015)

• Record Type: Journal Article
• Authors: Göçmez, Cüneyt; Koc, Rahmi K.; Tucer, Bulent; Menku, Ahmet; Kurtsoy, Ali
• Is Part Of: Neurosurgery quarterly. Volume 25:Issue 1(2015)
• Publication Date: 2015-02
• Subjects: myelopathy -- prognostic factors -- cervical spondylosis -- cervical spondylotic myelopathy; Nervous system -- Surgery -- Periodicals; 617.4805
• DOI: 10.1097/WNQ.0b013e3182a2fe31
• Languages: English
• ISSNs: 1050-6438

Abstract

Abstract : Objective: Various factors may affect the surgical outcome in patients with cervical spondylotic myelopathy (CSM). The purpose of the present study was to determine these factors based on preoperative radiologic and clinical data. Methods: A total of 50 patients who underwent surgery for CSM and were followed up for at least 12 months postoperatively were enrolled in the study. The patients' preoperative and final neurologic status was assessed using the Japan Orthopedic Association (JOA) scoring system. JOA scores and prognostic factors such as sex, age, duration of symptoms, sagittal alignment, number of disks compressed, signal intensity on T1-weighted and T2-weighted magnetic resonance (MR) images, and the diameter of the spinal channel were evaluated. Results: The average preoperative and postoperative JOA scores were 10.9±3.4 and 15.0±2.4, respectively. The mean percentage of improvement for patients with CSM was 62.6±25.0% ( P <0.05). The effects of sex difference, number of disks involved, and sagittal alignment on prognosis were not statistically significant ( P >0.05). However, patients younger than 50 years, with duration of symptoms <1 year and no signal increase on T2-weighted MR images were predicted to have more neurologic improvement ( P <0.05). Conclusions: We found that sex, number of degenerated disks, and sagittal alignment had no effect on prognosis. Notably, age below 50 years, duration of symptoms <1 year, and no signal increase on T2-weighted MR images affected surgical outcomes positively.