Showing 1 results for Cervical Spondylosis; Myelopathy; Anterior Cervical Decompression.
K Haddadian, O Rezaee, S Sadeghi, A Modarres Zamani, G Sharifi, A Ali Asgari,
Volume 18, Issue 4 (11-2005)
Abstract
We evaluated the specific pattern of pre- and postoperative neurological signs
and symptoms of cervical spondylotic myelopathy (CSM) to determine [mdings which
had a predictive value for surgical outcome. Consecutive patients with CSM caused by
osteophytic ridge or intervertebral disc herniation who underwent anterior cervical decompression
and fusion in Loghman Hakim Hospital from 1999-2003 were prospectively
enrolled. Patients were evaluated postoperatively by office visit. Outcome was
assessed by objective neurological examination and scoring with multiple functional
rating scales. Forty - three patients (30 male, 13 female) with a mean age of 48.8 years
fulfilled our inclusion criteria. The most common preoperative symptoms were sensory
deficit in distal upper limbs (88.4%), gait disturbance (69.8%) and sensory deficit of
distal lower limbs (58.1 %). The most common signs were hyperreflexia (95.3%),
Hoffman's sign (93%) and Babinski's sign (83.7%). Vertebral osteophyte and soft disc
herniation were found in 86% and 14% of the patients, respectively. Overall functional
improvement, evaluated by using a modification of the Japanese Orthopedic Association
Scale was noted in 79.7% of the patients who had an abnormal scale preoperatively.
Strength improved considerably and significantly after operation. However, less
than half of the patients experienced functional improvement in the lower limbs, a discrepancy
that was probably caused by persistent spasticity. Atrophy of the hand muscles,
preoperative spastic gait and cord atrophy as shown in MRI were poor prognostic
factors.
