Cervical Spondylotic Myelopathy:Postoperative Results and Prognostic Factors.
- Author:
Hyun Jib KIM
1
;
Chun Kee CHUNG
Author Information
1. Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Cervical spondylosis;
Spondylotic myelopathy;
Prognosis
- MeSH:
Constriction, Pathologic;
Decompression;
Follow-Up Studies;
Humans;
Mortality;
Neurologic Manifestations;
Prognosis;
Retrospective Studies;
Spinal Cord Diseases;
Spondylosis
- From:Journal of Korean Neurosurgical Society
1994;23(6):685-691
- CountryRepublic of Korea
- Language:English
-
Abstract:
There are many factors affecting surgical results of cervical spondylotic myelopathy. Age, duration of symptom, neurologic status, and direction of surgical approach are side to have prognostic implications. Also a high signal intensity on T2 weighted magnetic resonance imaging(HSI on T2WI) is insisted as a poor prognostic factor. We analyzed these factors in 56 patients treated over a 10-year period retrospectively. Statistical analysis was done using chi square, Mantel-Haenszel. Cochran-Mantel-Haenszel, Wilcoxon, and logistic procedure. We preferred anterior decompression when compressive lesions existed ventrally. However posterior decompression was performed in a 4 or more level stenosis. Age ranged from 22 to 74 year(mean : 50.8). 25 patients underwent the anterior procedure, 33 patients the posterior procedure, and 2 both procedures. Neurologic status was graded both preoperatively and at follow-up using the Nurick grading system from 1 to 5. The preoperative Nurick grade was 2.75+/-0.16(mean+/-SE). Mean follow-up period was 13.8 months(SE 0.14). The follow-up Nurick grade was 2.125+/-0.14, and these was noted an improvement of 0.63+/-0.12. The amount of improvement was equivalent between the anterior and the posterior approaches(0.52 vs. 0.73 respectively, p=0.67). There was no mortality. Uni- and multivariant analysis demonstrated that age, duration of symtom and HSI on T2WI had no significant effect on either follow-up Nurick grade or amount of improvement, but the preoperative Nurick grade had a significant effect(p<0.000). Comparable results can be obtained with either approaches if chosen properly. Only the preoperative Nurick grade has the prognostic value.
