Preoperative factors that predict fair outcomes following surgery in patients with proximal cervical spondylotic amyotrophy. A retrospective study.
Aged
Electromyography
Evoked Potentials, Motor
/ physiology
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Muscle Strength
/ physiology
Muscle, Skeletal
/ physiopathology
Muscular Atrophy, Spinal
/ etiology
Orthopedic Procedures
Outcome Assessment, Health Care
Preoperative Period
Retrospective Studies
Spondylosis
/ complications
Transcranial Magnetic Stimulation
Journal
Spinal cord
ISSN: 1476-5624
Titre abrégé: Spinal Cord
Pays: England
ID NLM: 9609749
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
received:
02
05
2019
accepted:
11
09
2019
revised:
21
08
2019
pubmed:
21
11
2019
medline:
16
2
2021
entrez:
21
11
2019
Statut:
ppublish
Résumé
Observational cohort study OBJECTIVES: To investigate preoperative factors that predict fair outcomes following surgery in patients with proximal cervical spondylotic amyotrophy (CSA) using electrophysiological and neurological findings. Yamaguchi University METHODS: 54 patients with proximal CSA who underwent surgical treatment of the cervical spine were enrolled. Erb-point stimulated compound muscle action potentials (CMAP) were recorded from the deltoid and biceps brachii muscles. We computed the ratio of affected to normal side CMAP amplitudes in two muscles (deltoid and biceps brachii) and regarded the mean ratio (CMAP-R) as representing the severity of neural involvement. Pre- and postoperative strengths of the most atrophic muscles were evaluated using manual muscle testing. Improvements in strength were classified as excellent (5 grades recovered), good (more than one grade recovered), fair (no improvement), or poor (worsened). Surgical outcomes were excellent in 26 patients, good in five, fair in 16, poor in seven. Patients with fair outcomes had lower CMAP-R than those patients with excellent and good outcomes [P = 0.0099, odds ratio = 0.89 (95% confidence interval, 0.81-0.97; for a change of 10%)]. Eight patients (15%) had a C5 palsy. CMAP-R could be used as a reliable predictive factor related to a fair surgical outcome. We must pay attention to the incidence of C5 palsy after surgery.
Identifiants
pubmed: 31745245
doi: 10.1038/s41393-019-0365-2
pii: 10.1038/s41393-019-0365-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
348-355Références
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