Evaluation of five scoring systems for cervical spondylogenic myelopathy

Dalitz, Kristina; Vitzthum, Hans-Ekkehart

doi:10.1016/j.spinee.2008.05.005

Cited by 23 publications

(11 citation statements)

References 7 publications

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“…However, one recent systemic review examining the validity, reliability, and responsiveness of existing clinical metrics found that NDI is not commonly used among CSM patients, while the mJOA and Nurick scores were among the most widely used metrics 33 . Moreover, studies comparing clinical scores among CSM patients have shown consistency between mJOA and Nurick scores with respect to their ability to measure postoperative recovery 34,35 . Notably, our study was small (n=13), which may have limited our ability to detect statistical differences.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Magnetization Transfer MRI Measurements of the Anterior Spinal Cord Region are Associated With Clinical Outcomes in Cervical Spondylotic Myelopathy

Cloney

Smith

Weber

et al. 2018

Spine

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Section: Discussionmentioning

confidence: 99%

Quantitative Magnetization Transfer MRI Measurements of the Anterior Spinal Cord Region are Associated With Clinical Outcomes in Cervical Spondylotic Myelopathy

Cloney

Smith

Weber

et al. 2018

Spine

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“…The questionnaires were obtained at the time of pre‐operative screening, post‐operative evaluation (1 month) and post‐operative follow‐up (3 months). Recovery after surgical treatment was calculated using a recovery ratio: (post‐operative mJOA score – pre‐operative mJOA score)/(17 – pre‐operative mJOA score) × 100% . A recovery ratio of greater than 50% was considered to be indicative of a positive outcome, whereas a ratio of less than 50% was indicative of no improvement.…”

Section: Methodsmentioning

confidence: 99%

High‐resolution diffusion tensor imaging in cervical spondylotic myelopathy: a preliminary follow‐up study

et al. 2017

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Diffusion imaging is a promising technique as it can provide microstructural tissue information and thus potentially show viable changes in spinal cord. However, the traditional single-shot imaging method is limited as a result of various image artifacts. In order to improve measurement accuracy, we used a newly developed, multi-shot, high-resolution, diffusion tensor imaging (DTI) method to investigate diffusion metric changes and compare them with T -weighted (T2W) images before and after decompressive surgery for cervical spondylotic myelopathy (CSM). T2W imaging, single-shot DTI and multi-shot DTI were employed to scan seven patients with CSM before and 3 months after decompressive surgery. High signal intensities were scored using the T2 W images. DTI metrics, including fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD), were quantified and compared pre- and post-surgery. In addition, the relationship between imaging metrics and neurological assessments was examined. The reproducibility of multi-shot DTI was also assessed in 10 healthy volunteers. Post-surgery, the mean grade of cervical canal stenosis was reduced from grade 3 to normal after 3 months. Compared with single-shot DTI, multi-shot DTI provided better images with lower artifact levels, especially following surgery, as a result of reduced artifacts from metal implants. The new method also showed acceptable reproducibility. Both FA and RD values from the new acquisition showed significant differences post-surgery (FA, p = 0.026; RD, p = 0.048). These changes were consistent with neurological assessments. In contrast, T2W images did not show significant changes before and after surgery. Multi-shot diffusion imaging showed improved image quality over single-shot DWI, and presented superior performance in diagnosis and recovery monitoring for patients with CSM compared with T2W imaging. DTI metrics can reflect the pathological conditions of spondylotic spinal cord quantitatively and may serve as a sensitive biomarker for potential CSM management.

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“…[2][3][4][5][6][7][8] The severity of gait difficulty is an essential item in the evaluation of CCM, and every disease-specific instrument for cervical myelopathy-such as the JOA score, Nurick score, and European Myelopathy Scoreincludes it as one of the evaluations of neurological manifestations. 36 In contrast, knowledge regarding postural instability in patients with CCM has been limited to comparisons with their gait difficulties. Postural instability is not directly considered in the aforementioned instruments.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Surgery on Postural Instability in Patients With Cervical Compressive Myelopathy

Yano

Fujishiro²,

Obo³

et al. 2021

Clinical Spine Surgery: A Spine Publication

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Objective: To investigate the effects of surgery on the subjective perception of bodily unsteadiness and the objective measurements of postural instability in patients with cervical compressive myelopathy (CCM).Summary of Background Data: Several studies have demonstrated that CCM patients have impaired postural stability and investigated its surgical outcomes. However, these studies have only objectively measured postural stability by using a stabilometer or three-dimensional motion capture system. There have been no studies examining the subjective perception of postural instability in CCM patients. Materials and Methods:We retrospectively reviewed patients who underwent decompressive surgery for CCM. The Fall Efficacy Scale-International (FES-I) and a self-prepared questionnaire were used to evaluate subjective perception of bodily unsteadiness. To objectively assess postural instability, a stabilometric analysis was performed with the following parameters: sway area (SwA, cm 2 ), sway velocity (SwV, cm/s), and sway density (SwD, /cm). The evaluations were performed preoperatively, during the early postoperative period (3-6 mo postoperatively), and at 1-year postoperatively in patients with CCM. The evaluation results were compared with age-matched, sex-matched, and body mass index-matched healthy subjects.Results: We included 70 CCM patients and 36 healthy subjects in this study. In both the FES-I and self-prepared questionnaire, CCM patients reported significantly milder postoperative bodily unsteadiness. The stabilometric parameters were significantly improved during the postoperative period when compared with preoperative values. Nevertheless, neither the self-reported outcome measures nor stabilometric parameters of CCM patients reached the levels of those in healthy controls in the postoperative period. Conclusion:This was the first study to examine CCM surgical outcomes in terms of both subjective perception and objective postural instability. While both objective postural stability and subjective perception improved following decompressive surgery, they did not reach the levels seen in healthy participants.

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Evaluation of five scoring systems for cervical spondylogenic myelopathy

Cited by 23 publications

References 7 publications

Quantitative Magnetization Transfer MRI Measurements of the Anterior Spinal Cord Region are Associated With Clinical Outcomes in Cervical Spondylotic Myelopathy

Quantitative Magnetization Transfer MRI Measurements of the Anterior Spinal Cord Region are Associated With Clinical Outcomes in Cervical Spondylotic Myelopathy

High‐resolution diffusion tensor imaging in cervical spondylotic myelopathy: a preliminary follow‐up study

The Effects of Surgery on Postural Instability in Patients With Cervical Compressive Myelopathy

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