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Abstract
Study Design
This is a retrospective study on the factors affecting the surgical results for cervical spondylotic myelopathy.
Objectives
We wanted to analyze the clinical and radiologic factors affecting the results of treatment for cervical spondylotic myelopathy patients who underwent anterior decompression with fusion or open door laminoplasty.
Summary of the Literature Review
Many authors have reported on the prognostic factors affecting the results of surgical treatment for cervical spondylotic myelopathy; some of the reported factors do affect the results, but there is a wide range of opinion about them.
Materials and Methods
We reviewed 38 patients who underwent anterior decompression with fusion or open door laminoplasty for cervical spondylotic myelopathy between March 1999 and Dec. 2003. We analyzed the factors, including age, the duration of symptoms, the symptomatic classification, the preoperative and postoperative JOA scores, the compression ratio of the spinal cord and the surgical method.
Result
The mean JOA score increased from 10.3± 3.4 preoperatively to 14.9± 4.6 postoperatively with a recovery rate of 69.0%± 21.24%. The preoperative JOA score and the compression ratio of the spinal cord on MRI correlated positively with the recovery rate. The patients’ age showed negative correlation with the recovery rate. There is no difference between the two surgical methods for the recovery rate.
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Fig. 2.
A fifty-two years old male visited our clinic because of weakness and gait disturbance. He is classified motor system syndrome and preoperative JOA score is 10. (A) Preoperative lateral radiograph showing congenital spinal canal stenosis (Pavlov ratio: 0.67) with degenerative spondylosis. (B) T2 weighted sagittal MRI demonstrating cord compression at C3-4, C4-5 and C5-6, showing high signal change in the spinal cord at the compression site. (C) Posterative lateral radiograph showing widened of spinal canal after open door laminoplasty. (D) Posterative CT axial image shows increased canal diameter (Recovery rate : 71.43%)
Fig. 3.
A forty-seven years old male visited our clinic because of upper extremity weakness and radicular pain. He is classified Brachalgia syndrome and preoperative JOA score is 12. (A) Preoperative lateral radiograph showing mild disc space narrowing at C5-6. (B) T2 weighted sagittal MRI demonstrating cord compression at C5-6. (C) Posterative lateral radiograph showing radiologic union and normal rodotic cervical curvature (Recovery rate : 80%).
Table 1.
Preoperative symptoms and signs
Table 2.
Correlation coefficents between surgical outcome and predictor
| Recovery Rate | P-value | |
|---|---|---|
| Age | -0.625 | 0.002 |
| Pre∗ JOA | -0.612 | 0.001 |
| Cord Compression Ratio | -0.573 | 0.007 |
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