Journal of Craniovertebral Junction and Spine

ORIGINAL ARTICLE
Year
: 2016  |  Volume : 7  |  Issue : 2  |  Page : 82--86

Prediction of surgical outcome in compressive cervical myelopathy: A novel clinicoradiological prognostic score


Rishi Anil Aggarwal, Sudhir Kumar Srivastava, Sunil Krishna Bhosale, Pradip Sharad Nemade 
 Department of Orthopaedics, Seth GS Medical College and King Edward Memorial (KEM) Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Rishi Anil Aggarwal
Department of Orthopaedics, Seth GS Medical College and King Edward Memorial (KEM) Hospital, Parel, Mumbai - 400 012, Maharashtra
India

Context: Preoperative severity of myelopathy, age, and duration of symptoms have been shown to be highly predictive of the outcome in compressive cervical myelopathy (CCM). The role of radiological parameters is still controversial. Aims: Define the prognostic factors in CCM and formulate a prognostic score to predict the outcome following surgery in CCM. Settings and Design: Retrospective. Materials and Methods: This study included 78 consecutive patients with CCM treated surgically. The modified Japanese Orthopaedic Association (mJOA) scale was used to quantify severity of myelopathy at admission and at 12-month follow-up. The outcome was defined as DQgoodDQ if the patient had mJOA score ≥16 and DQpoorDQ if the score was <16. Age, sex, duration of symptoms, comorbidities, intrinsic hand muscle wasting (IHMW), diagnosis, surgical technique, Torg ratio, instability on dynamic radiographs, and magnetic resonance imaging (MRI) signal intensity changes were assessed. Statistics: Statistical Package for the Social Sciences (SPSS) (version 20.0) was used for statistical analysis. The association was assessed amongst variables using logistic regression analysis. Parameters having a statistically significant correlation with the outcome were included in formulating a prognostic score. Results: Severity of myelopathy, IHMW, age, duration, diabetes, and instability on radiographs were predictive of the outcome with a P value <0.01. Genders, diagnosis, surgical procedure, Torg ratio, and intensity changes on MRI were not significantly related to the outcome. A 8-point scoring system was devised incorporating the significant clinicoradiological parameters, and it was found that nearly all patients (97.82%) with a score below 5 had good outcome and all patients (100%) with a score above 5 had poor outcome. The outcome is difficult to predict with a score of 5. Conclusions: Clinical parameters are better predictors of the outcome as compared to radiological findings, following surgery in CCM. A simple scoring system based on clinicoradiological parameters is suggested in this paper to predict the outcome following surgery in cases of CCM.


How to cite this article:
Aggarwal RA, Srivastava SK, Bhosale SK, Nemade PS. Prediction of surgical outcome in compressive cervical myelopathy: A novel clinicoradiological prognostic score.J Craniovert Jun Spine 2016;7:82-86


How to cite this URL:
Aggarwal RA, Srivastava SK, Bhosale SK, Nemade PS. Prediction of surgical outcome in compressive cervical myelopathy: A novel clinicoradiological prognostic score. J Craniovert Jun Spine [serial online] 2016 [cited 2021 Jan 18 ];7:82-86
Available from: https://www.jcvjs.com/article.asp?issn=0974-8237;year=2016;volume=7;issue=2;spage=82;epage=86;aulast=Aggarwal;type=0