Pandita Naveen, Gupta Sanjeev, Raina Prince, Srivastava Abhishek, Hakak Aamir Yaqoob, Singh Omeshwar, Darokhan Mohd Azhar-Ud-Din, Butt Mohd Farooq
Department of Spine Services, Primus Super Speciality Hospital, New Delhi, India.
Department of Orthopaedics, Government Medical College and Hospital, Jammu, India.
Asian Spine J. 2019 Jun;13(3):423-431. doi: 10.31616/asj.2018.0139. Epub 2019 Jan 29.
STUDY DESIGN: Prospective clinical study. PURPOSE: The present study aimed to examine the neurological recovery pattern in cervical spondylotic myelopathy (CSM) after anterior cervical decompression and compare it with the existing reports in the literature. OVERVIEW OF LITERATURE: Neurological recovery and regression of myelopathy symptoms is an important factor that determines the outcomes of surgical decompression. The present findings contribute to the literature on the pattern of neurological recovery and patient prognosis with respect to the resolution of myelopathy symptoms after surgery. METHODS: This prospective study was conducted in Government Medical College in Jammu, North India between November 2012 and October 2014, a total of 30 consecutive patients with CSM were included and treated with anterior decompression and stabilization. They were prospectively followed up for 1 year and were evaluated for their neurological recovery pattern. The postoperative outcome was evaluated using the modified Japanese Orthopaedic Association (mJOA) score. The recovery rate was calculated using Hirabayashi's method. The JOA score was assessed before the operation and postoperatively at 1 week, 2 weeks, 1 month, 3 months, 4 months, 6 months, and 1 year. RESULTS: The postoperative mJOA score was 0 in the 1st month, 12.90±3.57 in the 3rd month, 13.50±3.55 in the 4th month, 14.63±3.62 in the 6th month, and 14.9±3.24 at the final follow-up of 1 year. The average recovery rate during the 1st month followup was 0%, and that during the 3rd month follow-up was 12.91% with a range of 0%-50%. The average recovery rate during the 4th month was 32.5%, with a range of 0%-60%, while that during the 6th month was 72.83%, with a range of 0%-100%. The average recovery rate during the final follow-up of 1 year was 54.3%. CONCLUSIONS: Neurological recovery after surgical decompression starts from the 3rd postoperative month and progresses until the 6th postoperative month; thereafter, it gradually plateaus over the subsequent 6 months until it steadies. Symptom duration is an important factor that requires consideration while determining postoperative neurological recovery.
研究设计：前瞻性临床研究。 目的：本研究旨在探讨脊髓型颈椎病（CSM）前路减压术后的神经功能恢复模式，并与文献中的现有报道进行比较。 文献综述：神经功能恢复和脊髓病症状的消退是决定手术减压效果的重要因素。本研究结果有助于丰富关于手术后脊髓病症状消退时神经功能恢复模式和患者预后的文献。 方法：本前瞻性研究于2012年11月至2014年10月在印度北部查谟的政府医学院进行，共纳入30例连续的CSM患者，均接受前路减压和内固定治疗。对他们进行为期1年的前瞻性随访，并评估其神经功能恢复模式。采用改良日本骨科协会（mJOA）评分评估术后结果。采用平林法计算恢复率。在手术前以及术后1周、2周、1个月、3个月、4个月、6个月和1年时评估JOA评分。 结果：术后第1个月mJOA评分为0分，第3个月为12.90±3.57分，第4个月为13.50±3.55分，第6个月为14.63±3.62分，在1年的最终随访时为14.9±3.24分。第1个月随访期间的平均恢复率为0%，第3个月随访期间为12.91%，范围为0%-50%。第4个月的平均恢复率为32.5%，范围为0%-60%，而第6个月为72.83%，范围为0%-100%。1年最终随访时的平均恢复率为54.3%。 结论：手术减压后的神经功能恢复从术后第3个月开始，持续至术后第6个月；此后，在接下来的6个月中逐渐趋于平稳，直至稳定。症状持续时间是决定术后神经功能恢复时需要考虑的一个重要因素。
Rev Chir Orthop Reparatrice Appar Mot. 2005-11
Fluids Barriers CNS. 2023-9-25
AJR Am J Roentgenol. 2011-7
Spine (Phila Pa 1976). 2010-10-1
Br Med J. 1963-12-28
Zotero 插件