Prognostic Factors That Affect the Surgical Outcome of the Laminoplasty in Cervical Spondylotic Myelopathy

Overview

Journal Clin Orthop Surg

Specialty Orthopedics

Date 2010 Jun 2

PMID 20514267

Citations 23

Authors

Jae-Sung Ahn

June-Kyu Lee

Bo-Kun Kim

Affiliations

Soon will be listed here.

Abstract

Background: This study examined the prognostic factors that affect the surgical outcome of laminoplasty in cervical spondylotic myelopathy patients by comparative analysis.

Methods: Thirty nine patients, 26 males and 13 females, who were treated with laminoplasty for cervical myelopathy from September 2004 to March 2008 and followed up for 12 months or longer, were enrolled in this study. The mean age of the subjects was 62.4 years (range, 37 to 77 years). The patients' age, number of surgical segments, spinal cord compression ratio, segment number, level, localized marginal pattern of high signal intensity within the spinal cord in the T2 image, preoperative Japanese Orthopaedic Association Scoring System (JOA) score with the recovery ratio were compared respectively. The JOA score was used for an objective assessment of the patients' preoperative and postoperative clinical status. The recovery ratios of surgery were graded using the Hirabayashi equation. Statistical analysis was carried out using Pearson correlation analysis.

Results: The patients' JOA score increased from a preoperative score of 11.1 (range, 5 to 16) to a postoperative score of 14.9 (range, 7 to 17). The average recovery ratio was 65.8% (range, 0 to 100%). The number of segments with high signal changes in the T2 image, a localized marginal pattern with high signal change, signal intensity changes in the upper cervical spinal cord were inversely associated with the recovery ratio, whereas the spinal cord compression ratio showed a significant positive correlation. However, the currently known prognostic factors, such as number of surgical segment, age, and preoperative JOA score, showed no statistically significant correlation.

Conclusions: The number of segments, localized marginal pattern, rostral location of signal intensity changes with a high signal change in the T2 image and a low spinal cord compression ratio in cervical spondylotic myelopathy patients treated by laminoplasty can indicate a poor prognosis.

Citing Articles

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Impaired communication at the neuromotor axis during Degenerative Cervical Myelopathy.

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Preoperative T1 magnetic resonance imaging changes carry a poor postoperative prognosis in cervical myelopathy: A retrospective study of 182 patients.

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Using a Combined Classification of Increased Signal Intensity on Magnetic Resonance Imaging (MRI) to Predict Surgical Outcome in Cervical Spondylotic Myelopathy.

Ren H, Feng T, Wang L, Liu J, Zhang P, Yao G Med Sci Monit. 2021; 27:e929417.

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