Cervical spondylotic myelopathy: the prediction of outcome following surgical intervention in 93 patients using T1- and T2-weighted MRI scans

• Published in: European spine journal 2015-12, Vol.24 (12), p.2930-2935
• Main Authors: Salem, Hatem M. I., Salem, Khalid M. I., Burget, Filip, Bommireddy, Raj, Klezl, Zdenek
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Cervical Vertebrae - surgery; Decompression, Surgical - methods; Female; Humans; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Neurosurgery; Original Article; Predictive Value of Tests; Prospective Studies; Spinal Cord Diseases - diagnosis; Spinal Cord Diseases - surgery; Spondylosis - surgery; Surgical Orthopedics; Young Adult
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-015-4028-5

Introduction Cervical spondylotic myelopathy (CSM) can lead to significant disability through a spectrum of clinical manifestations ranging from dexterity loss to more profound weakness, incontinence and paralysis. Aim To determine the outcome of surgical decompression for CSM and investigate pre-operative predictors of outcome. Methods Prospectively collected data on all patients who underwent decompressive surgery for CSM and completed 12-month follow-up were reviewed. Data on age, MRI T1 and T2 signal changes pre-operatively, surgical approach and the Nurick’s Myelopathy Grade (NMG) was analysed pre-operatively and 1 year post-surgery. Results Data on 93 consecutive patients who underwent surgery for CSM were reviewed. Median age was 62 (23–94) years and 59 % were male. The median follow-up was 37 (17–88) months. The approach was anterior in 38 (42 %) patients, posterior in 55 (58 %); improvement was not significantly different when the two groups were compared. The number of levels decompressed increased with age ( p value