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First neurological symptoms in degenerative cervical myelopathy : does it predict the outcome?
- Publication Year :
- 2022
-
Abstract
- Purpose Degenerative cervical myelopathy (DCM) is the most common non-traumatic cause of spinal cord dysfunction. Prediction of the neurological outcome after surgery is important. The aim of this study was to analyze the relationship between first symptoms of DCM and the neurological outcome after surgery. Methods A retrospective analysis over a period of 10 years was performed. First symptoms such as cervicobrachial neuralgia, sensory and motor deficits and gait disturbances were evaluated regarding the postoperative neurological outcome. The modified Japanese Orthopedic Association Score (mJOA Score) was used to evaluate neurological outcome. Results In total, 411 patients (263 males, 64%) with a median age of 62.6 ± 12.1 years were included. Cervicobrachial neuralgia was described in 40.2%, gait disturbance in 31.6%, sensory deficits in 19% and motor deficits in 9.2% as first symptom. Patients with cervicobrachial neuralgia were significantly younger (median age of 58 years, p = 0.0005) than patients with gait disturbances (median age of 68 years, p = 0.0005). Patients with gait disturbances and motor deficits as first symptom showed significantly lower mJOA Scores than other patients (p = 0.0005). Additionally, motor deficits and gait disturbance were negative predictors for postoperative outcome according to the mJOA Score. Conclusion Motor deficits and gait disturbances as the first symptom of DCM are negative predictors for postoperative neurological outcome. Nevertheless, patients with motor deficits and gait disturbance significantly profit from the surgical treatment despite poor preoperative mJOA Score.
- Subjects :
- Male
Association score
medicine.medical_specialty
Medizin
Spinal Cord Diseases
Myelopathy
Humans
Medicine
Postoperative outcome
Orthopedics and Sports Medicine
Aged
Retrospective Studies
business.industry
Gait Disturbance
Middle Aged
Spinal cord
medicine.disease
Treatment Outcome
medicine.anatomical_structure
Anesthesia
Orthopedic surgery
Cervical Vertebrae
Surgery
Neurosurgery
Cervicobrachial neuralgia
business
Neck
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....838d1ada50eeeb298b82b1021eb989e2