Cervical Spondylotic Myelopathy: Patterns of Neurological Deficit and Recovery after Anterior Cervical Decompression

Chiles, Bennie W.; Leonard, Michael A.; Choudhri, Haroon; Cooper, Paul R.

doi:10.1097/00006123-199904000-00041

Cited by 203 publications

(115 citation statements)

References 35 publications

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“…This result corresponds with a statement given by Chiles et al (1999) [4], that preoperatively higher scores are predictive for better outcome.…”

Section: Discussionsupporting

confidence: 89%

“…Specifically, radicular symptoms improved in 58.2% of the patients, funicular symptoms in 49.9%. Similar results in clinical development were also found by Chiles et al (1999) [4].…”

Section: Clinical Datasupporting

confidence: 86%

“…The ability to compare various results that measure clinical deficits and outcome is a necessity for successful worldwide discussion about the disease and its treatment. The study presented here compares Nurick-score [21,22], Japanese orthopaedic association score (JOAscore) [34], Cooper-myelopathy-scale (CMS) [4], Proloscore [26] and European-myelopathy-score (EMS) [10] and analyses how they reflect outcome, clinical and diagnostic data in patients with cervical myelopathy.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of five specific scores for cervical spondylogenic myelopathy

2007

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The ability to compare various results that measure clinical deficits and outcome is a necessity for successful worldwide discussion about cervical spondylogenic myelopathy (CSM) and its treatment. There is hardly any information in literature how to value and compare outcome assessed by different scores. In a retrospective study we objectively evaluated the Nurick-score, Japanese-orthopaedic-association-score (JOA-Score), Cooper-myelopathyscale (CMS), Prolo-score and European-myelopathy-score (EMS) using the data of 43 patients, all of whom showed clinical and morphological signs of CSM and underwent operative decompression. The scores were assessed pre-and postoperatively. The correlation between the scoreresults, anamnesis, clinical and diagnostic data was investigated. All the scores show a statistically significant correlation and measure postoperative improvement. With exception of the Prolo-score all scores reflect clinical deficits of CSM. The Prolo-score rates the severity of CSM on the state of the economic situation above clinical symptoms. The main differences of the scores are shown in the number of patients showing postoperative improvement, varying between 33% (Nurick-score) and 81% (JOA-score). The recovery-rates, as a measure of the cumulative improvement of all the symptoms, show less variation (23-37%). The differences of the recovery-rate were only statistically significant between JOA-score, Nurick-score and EMS (P \ 0.05), whereas all the other scores showed no significant differences. To assess the postoperative successes, the evaluation of the recovery-rate is essential. There is no significant difference in the recovery-rate amongst the majority of the scores, which allows a good comparison of the results from different studies. Nevertheless, it is always important to differentiate the therapy results of CSM published worldwide.

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“…This result corresponds with a statement given by Chiles et al (1999) [4], that preoperatively higher scores are predictive for better outcome.…”

Section: Discussionsupporting

confidence: 89%

“…Specifically, radicular symptoms improved in 58.2% of the patients, funicular symptoms in 49.9%. Similar results in clinical development were also found by Chiles et al (1999) [4].…”

Section: Clinical Datasupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

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Analysis of five specific scores for cervical spondylogenic myelopathy

2007

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“…Several clinical measures of disease severity have been developed such as the Japanese Orthopaedic Association (JOA) [25], Nurick [38], and Chile's modified Japanese Orthopaedic Association (mJOA) [10] scoring systems. These popular scales provide the clinician with a metric to quantify the extent and progression of disease (Tables 1, 2, and 3).…”

Section: Clinical Presentation and Evaluationmentioning

confidence: 99%

Cervical Spondylotic Myelopathy: Pathophysiology, Clinical Presentation, and Treatment

Lebl¹,

Hughes²,

Cammisa³

et al. 2011

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

136

111

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“…3,[6][7][8][9][12][13][14][15]17,22,29,30,35,36 However, anterior cervical decompressive procedures such as ACDF or ACCF have also been reported to be associated with postoperative C-5 palsy. 5,27,34,36,37 Despite the knowledge that a C-5 palsy is a risk of either procedure, the relative risk of C-5 palsy with anterior versus posterior surgery remains uncertain.We hypothesized that there would be no difference in the postoperative C-5 palsy rate between ACCF and instrumented open-door laminoplasty. …”

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confidence: 99%

Anterior corpectomy versus posterior laminoplasty: is the risk of postoperative C-5 palsy different?

Gandhoke

Rowland

et al. 2011

FOC

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Object Both anterior cervical corpectomy and fusion (ACCF) and laminoplasty are effective treatments for selected cases of cervical stenosis. Postoperative C-5 palsies may occur with either anterior or posterior decompressive procedures; however, a direct comparison of C-5 palsy rates between the 2 approaches is not present in the literature. The authors sought to compare the C-5 palsy rate of ACCF versus laminoplasty. Methods The authors conducted a retrospective review of 31 ACCF (at C-4 or C-5) and 31 instrumented laminoplasty cases performed to treat cervical stenosis. The demographics of the groups were similar except for age (ACCF group mean age 53 years vs laminoplasty group mean age 62 years, p = 0.002). The mean number of levels treated was greater in the laminoplasty cohort (3.87 levels) than in the ACCF cohort (2.74 levels, p < 0.001). The mean preoperative Nurick grade of the laminoplasty cohort (2.61) was higher than the mean preoperative Nurick grade of the ACCF cohort (1.10, p < 0.001). Results The overall clinical follow-up rate was 100%. The mean overall clinical follow-up was 15 months. There were no significant differences in the estimated blood loss or length of stay between the 2 groups (p > 0.05). There was no statistical difference between the complication or reoperation rates between the 2 groups (p = 0.184 and p = 0.238). There were 2 C-5 nerve root pareses in each group. Three of the 4 patients recovered full deltoid function, and the fourth patient recovered nearly full deltoid function at final follow-up. There was no statistical difference in the rate of deltoid paresis (6.5%) between the 2 groups (p = 1). Conclusions Both ACCF and laminoplasty are effective treatments for patients with cervical stenosis. The authors found no difference in the rate of deltoid paresis between ACCF and laminoplasty to treat cervical stenosis.

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Cervical Spondylotic Myelopathy: Patterns of Neurological Deficit and Recovery after Anterior Cervical Decompression

Cited by 203 publications

References 35 publications

Analysis of five specific scores for cervical spondylogenic myelopathy

Analysis of five specific scores for cervical spondylogenic myelopathy

Cervical Spondylotic Myelopathy: Pathophysiology, Clinical Presentation, and Treatment

Anterior corpectomy versus posterior laminoplasty: is the risk of postoperative C-5 palsy different?

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