American Journal of Clinical Neurology and Neurosurgery
Articles Information
American Journal of Clinical Neurology and Neurosurgery, Vol.1, No.2, Sep. 2015, Pub. Date: Aug. 13, 2015
Impact of Preoperative Spinal Cord Signal Intensity and Symptom Duration on Surgical Outcome of the Patients with Cervical Spondylotic Myelopathy
Pages: 102-106 Views: 2041 Downloads: 844
Authors
[01] Farzad Omidi-Kashani, Orthopedic Research Center, Orthopedic Department, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
[02] Mohamed Hosein Ebrahimzadeh, Orthopedic Research Center, Orthopedic Department, Qaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
[03] Arezoo Naderimoghadam, Student Research Committee, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
[04] Hamid Amanzadeh, Orthopedic Department, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract
Background: Cervical spondylotic Myelopathy (CSM) is one of the most common causes of cervical spinal cord dysfunction in old patents and in those cases with refractory complains, surgical decompression may become necessary. We aim to evaluate the impact of preoperative spinal cord signal change and symptom duration on surgical outcome of these patients. Material & Method: In this retrospective study, we reviewed 36 patients (25 male and 11 female) with CSM and mean age 55.7±13.2 who were surgically treated in our orthopedic department. Preoperative duration of myelopathic symptoms, disability status (according to Neck Disability Index; NDI), signal change inside the cervical spinal cord (on T2-weighted magnetic resonance imaging; T2 MRI), and surgical outcome (based on Odom’s criteria) were especially assessed. Statistical Package for the Social Sciences (SPSS) software version 16 was used for statistics and P value<0.05 was interpreted as significance. Results: Mean duration of preoperative symptoms and follow-up periods were 17.5±7.9 and 37.5±8 months, respectively. Spinal cord signal intensity in T2 MRI was normal in 21 (58.3%), light in 9 (25%), and tense in 6 (16.7%). Surgery could improve NDI scores from 27±9.3 preoperatively to 11.4±12 at the last follow-up visit. Excellent or good surgical outcome could achieve in 28 patients (77.8%). Among the various patients’ characteristics, only preoperative symptom duration and cord enhancement could show a significant correlation with patient’s disability improvement and surgical outcome. Conclusions: Outcome of surgery in CSM is satisfactory in most of the patients although, preoperative duration of myelopathic symptoms and spinal cord signal enhancement were associated with lower disability improvement and poorer surgical outcome.
Keywords
Spondylosis, Cervical Cord, Outcome Assessment, Magnetic Resonance Imaging
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