The value of a new method for assessing the separate functions of the long tracts and involved segments in patients with cervical myelopathy

Abstract

In order to assess accurately lesions of the spinal cord in patients with cervical myelopathy we have developed a new method of examination, which is based on the Japanese Orthopaedic Association (JOA) scoring system. The method attempts to assess separately the functions of the long tract and any involved cord segments in respect to the period after treatment. It was used in 117 consecutive patients who were divided into 2 groups based on whether or not there was a T2-highintensity lesion within the spinal cord, as revealed by a preoperative magnetic resonance imaging scan (MRI). The results of this method correlated well with the MRI findings. It was assumed that the degree of function of the upper limbs in patients with a T2-high-intensity lesion revealed more about a segment than about the long tract.Résumé Pour évaluer les lésions médullaires dans la myélopathie cervicale, nous avons développé une métho-de d'examen basée sur la classification de l'Association Orthopédique Japonaise (JOA). La méthode essaie d'évaluer les fonctions de l'ensemble médullaire et du segment concerné après une période de traitement. 117 malades consécutifs ont été divisés en deux groupes selon qu'il y avait ou non un signal d'hyper-intensité en T2 sur l'IRM pré-opératoire. Les résultats selon cette méthode ont été en corrélation avec les résultats IRM.

Duration of symptoms in the quantification of upper limb disability and impairment for individuals with mild degenerative cervical myelopathy (DCM)

“…Our results indicate that it is critical to consider quantitative sensory impairment in addition to measuring strength and dexterity in the neurological assessments of mild DCM patients, as loss of sensation is the primary complaint among these patients [20] and early in the disease progression reduced sensation is the main factor contributing to UL disability. A similar set of relationships is seen when the group is stratified by UL mJOA, however, sensation plays a significant role in both mild and moderate severity with this classification of the mJOA [16]. All three components of impairment remained significant through the mild and moderate ranges of severity, again leaving strength as the single significant factor at the severe stage.…”

“…The mJOA stratification followed previously defined cut points of the DCM population (5). A second stratification was performed to be more specific in relation to the UL (mJOA UL), as previously characterized [16]. The UL sensation and UL motor subscores of the mJOA were summed and used to stratify the sample for the analysis of duration of symptoms to ensure the deficit was specific to the upper limb.…”

Cervical myelopathy due to single level prolapsed disc and spondylosis: a comparative study on outcome between two groups

“…Hirabayashi et al assumed that the degree of function of the upper limbs in patients with T2-high intensity lesion revealed more about a segment than about the long tract [18].…”

Do Quantitative Magnetic Resonance Imaging Parameters Correlate With the Clinical Presentation and Functional Outcomes After Surgery in Cervical Spondylotic Myelopathy? A Prospective Multicenter Study

“…30 All our patients were followed up postoperatively at 2 time points (6 and 12 mo), considered to be the optimal points in recovery after decompressive surgery. Our study found that both STS and LTS functions are affected equally (with similar correlation coeffi cients, both being statistically signifi cant) when the spinal cord is compressed.…”