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Analysis of five specific scores for cervical spondylogenic myelopathy

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Abstract

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-myelopathy-scale (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 score-results, 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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References

  1. Batzdorf U, Batzdorf A (1988) Analysis of cervical spine curvature in patients with cervical spondylosis. Neurosurgery 22:827–836

    Article  PubMed  CAS  Google Scholar 

  2. Bohlmann HH. (1995) Cervical spondylosis and myelopathy. Instr Course Lect 44:81–98

    Google Scholar 

  3. Chagas H, Domingues F, Aversa A et al (2005) Cervical spondylotic myelopathy: 10 years of prospective outcome analysis of anterior decompression and fusion. Surg Neurol 64(Suppl 1):30–35 (discussion: 35–36)

    Article  Google Scholar 

  4. Chiles BWR, Leonard MA, Choudhri HF et al (1999) Cervical spondylotic myelopathy: patterns of neurological deficit and recovery after anterior cervical decompression. Neurosurgery 44(4):762–769 (discussion: 769–770)

    Article  PubMed  Google Scholar 

  5. Cooper PR, Epstein F (1985) Radical resection of intramedullary spinal cord tumors in adults. Recent experience in 29 patients. J Neurosurg 63:492–499

    PubMed  CAS  Google Scholar 

  6. Davis R (1996) A long-term outcome study of 170 surgically treated patients with compressive cervical radiculopathy. Surg Neurol 46:523–533

    Article  PubMed  CAS  Google Scholar 

  7. Emery SE. (2001) Cervical spondylotic myelopathy: diagnosis and treatment. J Am Acad Orthop Surg 9(6):376–388

    PubMed  CAS  Google Scholar 

  8. Fessler RG, Steck JC, Giovanini MA (1998) Anterior cervical corpectomy for cervical spondylotic myelopathy. Neurosurgery 34(2):257–265

    Article  Google Scholar 

  9. Harada A, Mimatsu K. (1992) Postoperative changes in the spinal cord in cervical spondylotic myelopathy demonstrated by magnetic resonance imaging. Spine 17:1275–1280

    Article  PubMed  CAS  Google Scholar 

  10. Herdmann J, Linzbach M, Krzan M et al (1994) The European myelopathy score. In: Baucher BL, Brock M, Klinger M (eds) Advances in neurosurgery. Springer, Berlin, pp 266–268

    Google Scholar 

  11. Hirabayashi K, Miyakawa J, Satomi K et al (1981) Operative results and postoperative progression of ossification among patients with cervical posterior longitudinal ligament. Spine 6(4):354–364

    Article  PubMed  CAS  Google Scholar 

  12. Houten JK, Cooper PR. (2003) Laminectomy and posterior cervical plating for multilevel cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament: effects on cervical alignment, spinal cord compression, and neurological outcome. Neurosurgery 52(5):1081–1087 (discussion: 1087–1088)

    Article  PubMed  Google Scholar 

  13. Hukuda S, Xiang LF, Imai S et al (1996) Large vertebral body, in addition to narrow spinal canal, are risk factors for cervical myelopathy. J Spinal Disord 9:177–186

    Article  PubMed  CAS  Google Scholar 

  14. Jörg J. (1992) Rückenmarkerkrankungen. VCH Weinheim, Basel, Cambridge

    Google Scholar 

  15. Keller A, von Ammon K, Klaiber R et al (1993) Die spondylogene zervikale myelopathie: konservative und operative Therapie. Schweiz Med Wochenschau 123:1682–1691

    CAS  Google Scholar 

  16. King JTJ, Moossy JJ, Tsevat J et al (2005) Multimodal assessment after surgery for cervical spondylotic myelopathy. J Neurosurg Spine 2(5):526–534

    Article  PubMed  Google Scholar 

  17. King JT, McGinnis KA, Roberts MS (2003) Quality of life assessment with the medical outcomes study short-form-36 among patients with cervical spondylotic myelopathy. Neurosurgery 52(1):113–121

    Article  PubMed  Google Scholar 

  18. Law MDJ, Bernhardt M, White AA (1995) 3rd. Evaluation and management of cervical spondylotic myelopathy. Instr Course Lect 44:99–110

    Google Scholar 

  19. Lyu RK, Tang LM, Chen CJ et al (2004) The use of evoked potentials for clinical correlation and surgical outcome in cervical spondylotic myelopathy with intramedullary high signal intensity on MRI. J Neurol Neurosurg Psychiatry 75(2):256–261

    PubMed  CAS  Google Scholar 

  20. Naderi S, Özgen S, Pamir MN et al (1998) Cervical spondylotic myelopathy: surgical results and factors affecting prognosis. Neurosurgery 43(1):43–49 (discussion: 49–50)

    Article  PubMed  CAS  Google Scholar 

  21. Nurick S (1972) The pathogenesis of the spinal cord disorder associated with cervical spondylosis. Brain 95(1):87–100

    Article  PubMed  CAS  Google Scholar 

  22. Nurick S (1972) The natural history and the results of surgical treatment of the spinal cord disorder associated with cervical spondylosis. Brain 95(1):101–108

    Article  PubMed  CAS  Google Scholar 

  23. Orr RD, Zdeblick TA. (1999) Cervical spondylotic myelopathy. Approaches to surgical treatment. Clin Orthop 359:58–66

    Article  PubMed  Google Scholar 

  24. Pallis C, Jones AM, Spillane JD (1954) Cervical spondylosis. Brain 77:274–289

    Article  PubMed  CAS  Google Scholar 

  25. Payne EE (1959) The cervical spine and spondylosis. Neurochirurgia 1:178–196

    PubMed  CAS  Google Scholar 

  26. Prolo D, Oklund SA, Butcher M (1986) Toward uniformity in evaluating results of lumbar spine operations. A paradigm applied to posterior lumbar interbody fusions. Spine 11(6):601–606

    Article  PubMed  CAS  Google Scholar 

  27. Rajshekhar V, Kumar GS (2005) Functional outcome after central corpectomy in poor-grade patients with cervical spondylotic myelopathy or ossified posterior longitudinal ligament. Neurosurgery 56(6):1279–1284 (discussion: 1284–1285)

    Article  PubMed  Google Scholar 

  28. Rattcliff J, Voorhies RM. (2001) Outcome study of surgical treatment for axial neck pain. South Med J 94(6):595–602

    Google Scholar 

  29. Restuccia D, Di Lazzaro V, Lo Monaco M et al (1992) Somatosensory evoked potensials in the diagnosis of cervical spondylotic myelopathy: preliminary data. Electromyogr Clin Neurophysiol 32:389–395

    PubMed  CAS  Google Scholar 

  30. Schön H (1999) Stellenwert der somatosensibel evozierten Potentiale in der prä- und postoperativen Beurteilung der zervikalen spondylophytär bedingten Myelopathie. Innaugural dissertation Leipzig 92

  31. Suda K, Abumi K, Ito M et al (2003) Local kyphosis reduces surgical outcomes of expansive open-door laminoplasty for cervical spondylotic myelopathy. Spine 28(12):1258–1262

    Article  PubMed  Google Scholar 

  32. Yamazaki T, Yanaka K, Uemura K et al (2003) Cervical spondylotic myelopathy: surgical results and factors affecting outcome with special reference to age differences. Neurosurgery 52(1):122–126

    Article  PubMed  Google Scholar 

  33. Yonenbou K, Fuji T, Ono K et al (1985) Choice of surgical treatment for multisegmental cervical spondylotic myelopathy. Spine 10:710–716

    Article  Google Scholar 

  34. Yue WM, Tan SB, Tan MH et al (2001) The Torg-Pavlov-ratio in cervical spondylotic myelopathy: a comparative study between patients with cervical spondylotic myelopathy and a nonspondylotic, nonmyelopathic population. Spine 26(16):1760–1764

    Article  PubMed  CAS  Google Scholar 

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  1. Neurosurgical clinic of the University Leipzig, Liebigstr. 20, 04103, Leipzig, Germany

    Hans-Ekkehart Vitzthum & Kristina Dalitz

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  1. Hans-Ekkehart Vitzthum
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  2. Kristina Dalitz
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Correspondence to Hans-Ekkehart Vitzthum.

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Vitzthum, HE., Dalitz, K. Analysis of five specific scores for cervical spondylogenic myelopathy. Eur Spine J 16, 2096–2103 (2007). https://doi.org/10.1007/s00586-007-0512-x

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  • DOI: https://doi.org/10.1007/s00586-007-0512-x

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