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脊髓病残疾指数:确定退行性颈椎脊髓病患者轻度、中度和重度损伤的标准。

Myelopathy disability index: establishing criteria for mild, moderate and severe impairment in patients with degenerative cervical myelopathy.

机构信息

Spine Research Unit, Vall d'Hebron Research Institute, Barcelona, Spain.

Spine Unit. Orthopaedic Department, Vall d'Hebron Hospital, Barcelona, Spain.

出版信息

Eur Spine J. 2023 Feb;32(2):584-589. doi: 10.1007/s00586-022-07506-2. Epub 2023 Jan 3.


DOI:10.1007/s00586-022-07506-2
PMID:36596911
Abstract

PURPOSE: To find the cut-off values in the Myelopathy Disability Index (MDI) that will allow us to classify the severity of Degenerative Cervical Myelopathy (DCM) into mild, moderate and severe. METHODS: Cross-sectional study with prospective data collection, with a total of 64 patients diagnosed with Degenerative Cervical Myelopathy (DCM). Anthropometric, diagnostic, neurological, functional and quality of life variables were collected. A Receiver Operating Curve (ROC) was performed. The cut-off points were validated by comparing the functional status of patients in the 3 groups and their Nurick scores. RESULTS: Sixty-four patients (23 women) with a mean age of 61.97 (SD 11.57) participated in this study. The majority of patients were Nurick I (28.13%) and Nurick II (32.81%). The medium MDI was 7.36 (SD 6.66) and the mJOA was 14.08 (SD 2.57). The mild-moderate cut-off value was between 4 and 5, with an Area Under the Curve (AUC) of 0.805, sensitivity of 0.853 and specificity of 0.6. For moderate-severe, the cut-off value obtained was between 7 and 8, with an AUC of 0.862, sensitivity of 0.857 and specificity of 0.684. Patients with greater severity had significantly lower functionality, with a P-value of 0.004 in the 30 Metre Walking Test and 0.005 in the Nine-Hole Peg Test. Established severity groups were also significantly related to the different categories of the Nurick score (P-value = 0.000). CONCLUSION: MDI values between 0 and 4 correspond to mild DCM, between 5 and 7 would be moderate DCM and from 8 to 30 indicate severe DCM.

摘要

目的:寻找 Myelopathy Disability Index(MDI)的截断值,以便将 Degenerative Cervical Myelopathy(DCM)的严重程度分为轻度、中度和重度。 方法:这是一项具有前瞻性数据收集的横断面研究,共纳入 64 例确诊为 Degenerative Cervical Myelopathy(DCM)的患者。收集了人体测量学、诊断、神经学、功能和生活质量变量。进行了接收器工作特征曲线(ROC)分析。通过比较 3 组患者的功能状态及其 Nurick 评分,验证了截断值。 结果:共有 64 名患者(23 名女性)参与了这项研究,平均年龄为 61.97(SD 11.57)岁。大多数患者为 Nurick I(28.13%)和 Nurick II(32.81%)。MDI 的中位数为 7.36(SD 6.66),mJOA 为 14.08(SD 2.57)。轻度至中度的截断值在 4 到 5 之间,曲线下面积(AUC)为 0.805,灵敏度为 0.853,特异性为 0.6。对于中度至重度,获得的截断值在 7 到 8 之间,AUC 为 0.862,灵敏度为 0.857,特异性为 0.684。严重程度较高的患者功能明显下降,30 米步行测试的 P 值为 0.004,九孔插棒测试的 P 值为 0.005。不同严重程度的分组与不同的 Nurick 评分类别也有显著相关性(P 值=0.000)。 结论:MDI 值在 0 到 4 之间对应于轻度 DCM,5 到 7 之间对应于中度 DCM,8 到 30 之间对应于重度 DCM。

相似文献

[1]
Myelopathy disability index: establishing criteria for mild, moderate and severe impairment in patients with degenerative cervical myelopathy.

Eur Spine J. 2023-2

[2]
The modified Japanese Orthopaedic Association scale: establishing criteria for mild, moderate and severe impairment in patients with degenerative cervical myelopathy.

Eur Spine J. 2017-1

[3]
Degenerative cervical myelopathy: establishing severity thresholds for neuromotor dysfunction in the aging spine using the NIH Toolbox Assessment Scale.

Geroscience. 2024-4

[4]
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[5]
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Br J Neurosurg. 2023-10

[6]
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Spine J. 2021-10

[7]
Characteristics of Upper Limb Impairment Related to Degenerative Cervical Myelopathy: Development of a Sensitive Hand Assessment (Graded Redefined Assessment of Strength, Sensibility, and Prehension Version Myelopathy).

Neurosurgery. 2020-3-1

[8]
Efficacy and Safety of Surgery for Mild Degenerative Cervical Myelopathy: Results of the AOSpine North America and International Prospective Multicenter Studies.

Neurosurgery. 2019-4-1

[9]
Outcomes of Surgical Decompression in Patients With Very Severe Degenerative Cervical Myelopathy.

Spine (Phila Pa 1976). 2018-8

[10]
Efficacy and safety of surgical decompression in patients with cervical spondylotic myelopathy: results of the AOSpine North America prospective multi-center study.

J Bone Joint Surg Am. 2013-9-18

引用本文的文献

[1]
Degenerative cervical myelopathy: establishing severity thresholds for neuromotor dysfunction in the aging spine using the NIH Toolbox Assessment Scale.

Geroscience. 2024-4

[2]
Letter to the Editor concerning "Myelopathy disability index: establishing criteria for mild, moderate and severe impairment in patients with degenerative cervical myelopathy" by Pons Carreto A et al. (Eur Spine J; 2023: 10.1007/s00586-022-07506-2).

Eur Spine J. 2023-4

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