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Journal of Neurosurgical Sciences 2012 December;56(4):349-55

lingua: Inglese

Surgical outcome of anterior decompression in cervical spondylotic myelopathy in patients with less cord derangement

Sharifi G., Alavi E., Haddadian K., Rezaee O., Aliasgari A., Faramarzi F.

Department of Neurosurgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran


AIM: CSM patients caused by osteophytic ridge or intervertebral disc herniation underwent anterior decompression and fusion were prospectively enrolled. The purpose was to elucidate the effects of decompression (anterior cervical discectomy and fusion) on myelopathic cord in milder cases, younger patients, and in short duration of the disease.
METHODS: Forty-three patients with CSM were examined comprising Cooper and mJOA scale before and after surgery and followed for 12 months.
RESULTS: Patients included in the study were 30 males and 13 females. The mean age of men was 50.9±13.2, and that of women was 46.8±11.8. The mean interval from symptoms onset to hospital presentation was 10.78±7.3 months.
In lower limbs, among 31 with preoperative functional impairment, 25 remained unchanged, three improved and three worsened, which is not significant, and of 39 patients with preoperative upper limb functional impairments using Cooper’s scale, 20 improved, 15 remained unchanged and 4 became worse (P=0.001). Recovery rate for mJOA score was 24.5±17.7%, for Cooper lower extremity score was 32.2±40.56% and for Cooper upper extremity score was 7.8±16.8%. The mean gain in mJOA was 0.84 (±0.57).
CONCLUSION: Patients with short duration of symptom onset respond remarkably to decompression surgery. In patients with good condition that myelopathy has not established yet, perhaps mJOA is not a perfect and powerful scale for pre and postoperative assessment of patient.

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