Approaches to spondylotic cervical myelopathy: conservative versus surgical results in a 3-year follow-up study.

Spine (Phila Pa 1976) 2002 Oct;27(20):2205-10; discussion 2210-1

Department of Neurology, Faculty Hospital of Brno, Czech Republic.

Study Design: A 3-year prospective randomized study was conducted.

Objective: To compare conservative and operative treatments of mild and moderate, nonprogressive, and slowly progressive forms of spondylotic cervical myelopathy.

Summary Of Background: DATA It is not known whether the results of decompressive surgery for the mild and moderate forms of spondylotic cervical myelopathy are any better than those of the conservative approach.

Methods: For this study, 68 patients were randomized into two groups. Group A, treated conservatively, consisted of 35 subjects, whereas Group B, treated surgically, was composed of 33 patients. The clinical outcome was evaluated by modified JOA score, timed 10-m walk, the score for daily activities recorded by video and evaluated by two observers blinded to the type of therapy, and subjective assessment by the patients themselves at months 6, 12, 24, and 36 of the follow-up period.

Results: There was, on the average, no significant deterioration in mJOA score in the two groups over the 3-year follow-up period, but there was a slightly expressed decrease in the self-evaluation score in Group B, and a slight deterioration of the score for daily activities in Group A. Comparison of the two groups showed a significant difference in the timed 10-m walk test favoring group A, but no difference in mJOA score or self-evaluation by the patients themselves, with the exception of a better score at month 6 in favor of Group B.

Conclusions: The 3-year follow-up study did not show, on the average, that the surgery is superior to conservative treatment for mild and moderate forms of spondylotic cervical myelopathy.

Download full-text PDF

Source
http://dx.doi.org/10.1097/01.BRS.0000029255.77224.BBDOI Listing
October 2002
9 Reads

Publication Analysis

Top Keywords

spondylotic cervical
16
3-year follow-up
12
forms spondylotic
12
cervical myelopathy
12
mild moderate
12
10-m walk
8
timed 10-m
8
follow-up study
8
moderate forms
8
mjoa score
8
daily activities
8
group treated
8
score daily
8
score
7
group
6
study
5
therapy subjective
4
average deterioration
4
deterioration mjoa
4
type therapy
4

Similar Publications